ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Advanced Search

Hepatic Hemodynamics (HD) and Portal Flow Modulation (PM): Tactical Use in Small for Size (SFS) Live Donor Liver Transplantation (LDLT).

T. Mansour,1 J. Pisa,1 E. Przybyszewski,1 J. Guarrera,1 K. Tomoaki,1 B. Samstein,1 K. Halazun,2 A. Griesemer,1 J. Emond.1

1Surgery, Columbia University Medical Center, New York
2Surgery, Weill Cornell Medical Center, New York.

Meeting: 2016 American Transplant Congress

Abstract number: 236

Keywords: Graft function, Hemodynamics, Liver transplantation, Portal veins

Session Information

Date: Monday, June 13, 2016

Session Name: Concurrent Session: Living Donor Liver Transplantation

Session Time: 2:30pm-4:00pm

 Presentation Time: 2:54pm-3:06pm

Location: Room 210

Related Abstracts
  • The Correlation of Hepatic and Systemic Hemodynamics During Liver Transplantation: Quantification of Hepatic Resistance as an Actual Value.
  • Outcomes Between ABO-Incompatible Living Donor Liver Transplantation (LDLT) and ABO-Compatible LDLT: A Matched Study

Objectives:

Efforts to reduce the risk of donor hepatectomy have resulted in smaller grafts for transplantation. Grafts below 0.8% of recipient body weight (GW/RW), have been defined as SFS and have traditionally had worse outcomes. Reduction of excess portal flow (PF) may be protective of graft injury in SFS LDLT though there is no consensus on the indications for and the results of PM. Three related issues need to be clarified, the relation of hepatic hemodynamics to graft size, the efficacy of PM to improve hepatic flows, and the relationship of HD to graft function and outcomes. In this study we sought to define the relationship between HD and graft outcomes, and determine the effect of PM.

Methods:

70 LDLT between Sep.2009 and Jul.2015 were enrolled in a single center cohort study of HD and PM. 34 were right lobes and 36 were left lobes with GW/BW ranging from 0.47% to 4.63%. 30 subjects (43%) had GW/BW <.08. PM was performed in 21 (33%). Outcome variables included function (day 7 bilirubin), ascites formation, and graft survival.

Results:

After reperfusion hepatic artery flow (HAF) was (162.7±157.6) ml/min, PF was (1179.5±719.3)ml/min and portal pressure (PP) was (14.8±5.2)mmHg. Mean PP was 13±4 in subjects without PM and 19.3±4.9 in subjects with PM (P=0.0001). After PM (n=21), there was 30%±14 reduction in PP, a 35%±19 decrease in PF and a 38%±24 increase in HAF.Graft function was assessed with respect to final HD after all modulations. Functional consequences of HD were observed when GW/BW was below 0.8%. Further analysis was conducted to identify cut-off values for final HD associated with significant changes in postoperative graft function. In subjects with GWRW < 0.8%, day 7 bilirubin was significantly higher when final PP >11 mmHg; (7.4±6.4 vs 2.3±2.3 p= .032) and final HAF below .25ml/gm.(P=.01). Graft survival not different based on graft size; 83.3% when GW/BW <0.8 and 82.5% in GW/BW >0.8.

Conclusion:

Our findings demonstrate expected results of PM when performed in a single center with a consistent approach. HD at the end of the procedure were correlated with functional assessment of graft function. In this setting SFS were used with survival comparable results to larger grafts. A larger cohort using a defined protocol will be needed to validate these observations.

CITATION INFORMATION: Mansour T, Pisa J, Przybyszewski E, Guarrera J, Tomoaki K, Samstein B, Halazun K, Griesemer A, Emond J. Hepatic Hemodynamics (HD) and Portal Flow Modulation (PM): Tactical Use in Small for Size (SFS) Live Donor Liver Transplantation (LDLT). Am J Transplant. 2016;16 (suppl 3).

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Mansour T, Pisa J, Przybyszewski E, Guarrera J, Tomoaki K, Samstein B, Halazun K, Griesemer A, Emond J. Hepatic Hemodynamics (HD) and Portal Flow Modulation (PM): Tactical Use in Small for Size (SFS) Live Donor Liver Transplantation (LDLT). [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/hepatic-hemodynamics-hd-and-portal-flow-modulation-pm-tactical-use-in-small-for-size-sfs-live-donor-liver-transplantation-ldlt/. Accessed February 26, 2021.

« Back to 2016 American Transplant Congress

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Kidney Dialysis after Heart Transplantation: The Short and Long Term Outcomes
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Subtherapeutic Low Tacrolimus Trough Levels (≤3.5 Ng /ml) Are A Risk Factor For Acute Rejection And Creatinine Doubling.
  • Penis Transplantation: First U.S. Experience.
  • A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC).
  • Is There a Difference Between DCD and DBD Kidney Transplantation with Similar KDPI?
  • Low GFR after Kidney Donation Is Not Chronic Kidney Disease
  • Left-Sided Donor Nephrectomy Predisposes Living Kidney Donors to Latent Adrenal Insufficiency with Symptoms of Fatigue and Inferior Quality of Life.
  • Live Related Kidney Transplant Experience in Abuja, Nigeria – First Eight Cases Ever.

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2021 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.