Does intraoperative hepatic artery flow predict arterial complications after liver transplantation?

Osman Abbasoglu, Marlon F. Levy, Giuliano Testa, Samuel Obiekwe, Borisa S. Brkic, Linda W. Jennings, Robert M. Goldstein, Bo S. Husberg, Thomas A. Gonwa, Goran B. Klintmalm

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background. Little is known about the value of intraoperative hepatic artery (HA) flow measurement on the development of HA complications in orthotopic liver transplantation (OLT). We undertook this study to see whether assessing HA flow at the OLT helps predict posttransplant HA complications (HA thrombosis or stenosis). Methods. Four hundred and eleven consecutive OLT in 367 adult patients who received grafts between November 1992 and August 1995 were reviewed. Of these, 259 grafts in 255 patients with at least 1 year of follow-up and with complete data were studied. HA flow, portal vein flow, percentage of cardiac index going to HA (HA/CI), HA flow per 100 g of liver tissue, mean arterial pressure, central venous pressure, and CI were analyzed. Preservation injury was assessed by posttransplant alanine aminotransferase and aspartate aminotransferase levels. Results. Thirty-four patients with 35 grafts developed HA thrombosis or stenosis during a median follow-up time of 29 months. HA complications occurring within the first 100 days of OLT were classified as early complications. HA flow at the time of surgery and percentage of CI going to the liver were found to be significant variables in early HA complications. Hepatic hemodynamics were not different in the late HA complication group compared to the control. Systemic hemodynamics and posttransplant alanine aminotransferase and aspartate aminotransferase levels were similar in all three groups. Logistic regression analysis showed that patients with HA flows less than 400 ml/min were more than 5 times as likely to develop HA complications (risk ratio 5.1). Conclusions. HA flow measurement should be obtained at the time of OLT and may help to predict early but not late posttransplant HA complications. Patients with HA flows less than 400 ml/min or HA/CI values of less than 7% may carry a higher risk for HA stenosis or thrombosis and may need close surveillance to detect such problems.

Original languageEnglish (US)
Pages (from-to)598-601
Number of pages4
JournalTransplantation
Volume66
Issue number5
DOIs
StatePublished - Sep 15 1998
Externally publishedYes

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Hepatic Artery
Liver Transplantation
Pathologic Constriction
Thrombosis
Aspartate Aminotransferases
Alanine Transaminase
Transplants
Liver
Hemodynamics
Central Venous Pressure

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Abbasoglu, O., Levy, M. F., Testa, G., Obiekwe, S., Brkic, B. S., Jennings, L. W., ... Klintmalm, G. B. (1998). Does intraoperative hepatic artery flow predict arterial complications after liver transplantation? Transplantation, 66(5), 598-601. https://doi.org/10.1097/00007890-199809150-00008

Does intraoperative hepatic artery flow predict arterial complications after liver transplantation? / Abbasoglu, Osman; Levy, Marlon F.; Testa, Giuliano; Obiekwe, Samuel; Brkic, Borisa S.; Jennings, Linda W.; Goldstein, Robert M.; Husberg, Bo S.; Gonwa, Thomas A.; Klintmalm, Goran B.

In: Transplantation, Vol. 66, No. 5, 15.09.1998, p. 598-601.

Research output: Contribution to journalArticle

Abbasoglu, O, Levy, MF, Testa, G, Obiekwe, S, Brkic, BS, Jennings, LW, Goldstein, RM, Husberg, BS, Gonwa, TA & Klintmalm, GB 1998, 'Does intraoperative hepatic artery flow predict arterial complications after liver transplantation?', Transplantation, vol. 66, no. 5, pp. 598-601. https://doi.org/10.1097/00007890-199809150-00008
Abbasoglu, Osman ; Levy, Marlon F. ; Testa, Giuliano ; Obiekwe, Samuel ; Brkic, Borisa S. ; Jennings, Linda W. ; Goldstein, Robert M. ; Husberg, Bo S. ; Gonwa, Thomas A. ; Klintmalm, Goran B. / Does intraoperative hepatic artery flow predict arterial complications after liver transplantation?. In: Transplantation. 1998 ; Vol. 66, No. 5. pp. 598-601.
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abstract = "Background. Little is known about the value of intraoperative hepatic artery (HA) flow measurement on the development of HA complications in orthotopic liver transplantation (OLT). We undertook this study to see whether assessing HA flow at the OLT helps predict posttransplant HA complications (HA thrombosis or stenosis). Methods. Four hundred and eleven consecutive OLT in 367 adult patients who received grafts between November 1992 and August 1995 were reviewed. Of these, 259 grafts in 255 patients with at least 1 year of follow-up and with complete data were studied. HA flow, portal vein flow, percentage of cardiac index going to HA (HA/CI), HA flow per 100 g of liver tissue, mean arterial pressure, central venous pressure, and CI were analyzed. Preservation injury was assessed by posttransplant alanine aminotransferase and aspartate aminotransferase levels. Results. Thirty-four patients with 35 grafts developed HA thrombosis or stenosis during a median follow-up time of 29 months. HA complications occurring within the first 100 days of OLT were classified as early complications. HA flow at the time of surgery and percentage of CI going to the liver were found to be significant variables in early HA complications. Hepatic hemodynamics were not different in the late HA complication group compared to the control. Systemic hemodynamics and posttransplant alanine aminotransferase and aspartate aminotransferase levels were similar in all three groups. Logistic regression analysis showed that patients with HA flows less than 400 ml/min were more than 5 times as likely to develop HA complications (risk ratio 5.1). Conclusions. HA flow measurement should be obtained at the time of OLT and may help to predict early but not late posttransplant HA complications. Patients with HA flows less than 400 ml/min or HA/CI values of less than 7{\%} may carry a higher risk for HA stenosis or thrombosis and may need close surveillance to detect such problems.",
author = "Osman Abbasoglu and Levy, {Marlon F.} and Giuliano Testa and Samuel Obiekwe and Brkic, {Borisa S.} and Jennings, {Linda W.} and Goldstein, {Robert M.} and Husberg, {Bo S.} and Gonwa, {Thomas A.} and Klintmalm, {Goran B.}",
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T1 - Does intraoperative hepatic artery flow predict arterial complications after liver transplantation?

AU - Abbasoglu, Osman

AU - Levy, Marlon F.

AU - Testa, Giuliano

AU - Obiekwe, Samuel

AU - Brkic, Borisa S.

AU - Jennings, Linda W.

AU - Goldstein, Robert M.

AU - Husberg, Bo S.

AU - Gonwa, Thomas A.

AU - Klintmalm, Goran B.

PY - 1998/9/15

Y1 - 1998/9/15

N2 - Background. Little is known about the value of intraoperative hepatic artery (HA) flow measurement on the development of HA complications in orthotopic liver transplantation (OLT). We undertook this study to see whether assessing HA flow at the OLT helps predict posttransplant HA complications (HA thrombosis or stenosis). Methods. Four hundred and eleven consecutive OLT in 367 adult patients who received grafts between November 1992 and August 1995 were reviewed. Of these, 259 grafts in 255 patients with at least 1 year of follow-up and with complete data were studied. HA flow, portal vein flow, percentage of cardiac index going to HA (HA/CI), HA flow per 100 g of liver tissue, mean arterial pressure, central venous pressure, and CI were analyzed. Preservation injury was assessed by posttransplant alanine aminotransferase and aspartate aminotransferase levels. Results. Thirty-four patients with 35 grafts developed HA thrombosis or stenosis during a median follow-up time of 29 months. HA complications occurring within the first 100 days of OLT were classified as early complications. HA flow at the time of surgery and percentage of CI going to the liver were found to be significant variables in early HA complications. Hepatic hemodynamics were not different in the late HA complication group compared to the control. Systemic hemodynamics and posttransplant alanine aminotransferase and aspartate aminotransferase levels were similar in all three groups. Logistic regression analysis showed that patients with HA flows less than 400 ml/min were more than 5 times as likely to develop HA complications (risk ratio 5.1). Conclusions. HA flow measurement should be obtained at the time of OLT and may help to predict early but not late posttransplant HA complications. Patients with HA flows less than 400 ml/min or HA/CI values of less than 7% may carry a higher risk for HA stenosis or thrombosis and may need close surveillance to detect such problems.

AB - Background. Little is known about the value of intraoperative hepatic artery (HA) flow measurement on the development of HA complications in orthotopic liver transplantation (OLT). We undertook this study to see whether assessing HA flow at the OLT helps predict posttransplant HA complications (HA thrombosis or stenosis). Methods. Four hundred and eleven consecutive OLT in 367 adult patients who received grafts between November 1992 and August 1995 were reviewed. Of these, 259 grafts in 255 patients with at least 1 year of follow-up and with complete data were studied. HA flow, portal vein flow, percentage of cardiac index going to HA (HA/CI), HA flow per 100 g of liver tissue, mean arterial pressure, central venous pressure, and CI were analyzed. Preservation injury was assessed by posttransplant alanine aminotransferase and aspartate aminotransferase levels. Results. Thirty-four patients with 35 grafts developed HA thrombosis or stenosis during a median follow-up time of 29 months. HA complications occurring within the first 100 days of OLT were classified as early complications. HA flow at the time of surgery and percentage of CI going to the liver were found to be significant variables in early HA complications. Hepatic hemodynamics were not different in the late HA complication group compared to the control. Systemic hemodynamics and posttransplant alanine aminotransferase and aspartate aminotransferase levels were similar in all three groups. Logistic regression analysis showed that patients with HA flows less than 400 ml/min were more than 5 times as likely to develop HA complications (risk ratio 5.1). Conclusions. HA flow measurement should be obtained at the time of OLT and may help to predict early but not late posttransplant HA complications. Patients with HA flows less than 400 ml/min or HA/CI values of less than 7% may carry a higher risk for HA stenosis or thrombosis and may need close surveillance to detect such problems.

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