Portal Vein Flow as an Indicator of Liver Transplantation for Acute Liver Failure
1Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
2Department of Hepatology, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Meeting: 2018 American Transplant Congress
Abstract number: C243
Keywords: Liver failure, Liver transplantation
Session Information
Session Name: Poster Session C: Liver: Recipient Selection
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Liver transplantation is the most effective treatment for acute liver failure. Timing of liver transplantation is important to rescue the dying patients. This study aimed to find the surrogate of acute liver failure to perform liver transplantation in time.
Patients and methods: The acute liver failure patients whose portal blood flowed was measured by Doppler ultrasound were included in this study. The clinical characteristics including AST, ALT, model of end stage liver disease (MELD) scores and portal blood flow were all collected. Liver sizes were calculated by standard liver volume equation. The outcomes of the patients with or without liver transplantation were correlated to portal flow.
Results: Forty-seven patients, 41 males and 6 females, were included in this study. Most of the patients (45/47, 95.7%) had hepatitis B with acute flare up and liver failure. The median (interquartile) age was 53 (41-60) years old. The ranges of peak AST and ALT were from 83 to 4245.IU/L and from 29 to 5245IU/L, respectively. The median (interquartile range) level of total bilirubin was 26.6 (9.2) mg/dl. The range of highest MELD scores was from 18 to 40 when the patients were assessed for liver transplantation. Portal blood flow was measured simultaneously when the patients were assessed for liver transplantation. The portal flow was negatively correlated to MELD scores. Among 47 patients, 22 patients were transplanted, 18 patients died without liver transplantation and 7 patients recovered from acute liver failure. The median portal flow per 100gm of liver parenchyma was 28ml, 29.5ml and 85ml, respectively (p=0.026). Liver transplantation is indicated when portal flow was decreased to 34.5ml/100gm liver parenchyma with 85.7% of specificity and decreased to 24.5ml/100gm liver parenchyma with 100% of specificity in acute liver failure.
Conclusion:
Portal flow can be as a surrogate of irreversible acute liver failure. While portal flow was decreased to 24.5ml/100gm liver parenchyma in acute liver failure status, liver function is irreversible and liver transplantation is indicated.
CITATION INFORMATION: Cheng C-.H., Lee C., Wang Y-.C., Wu T-.H., Lee C-.F., Wu T-.J., Chou H., Chan K-.M., Lee W-.C. Portal Vein Flow as an Indicator of Liver Transplantation for Acute Liver Failure Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Cheng C-H, Lee C, Wang Y-C, Wu T-H, Lee C-F, Wu T-J, Chou H, Chan K-M, Lee W-C. Portal Vein Flow as an Indicator of Liver Transplantation for Acute Liver Failure [abstract]. https://atcmeetingabstracts.com/abstract/portal-vein-flow-as-an-indicator-of-liver-transplantation-for-acute-liver-failure/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress