Influence of endothelin-1 on hemodynamics during liver transplantation with and without temporary portocaval shunt: Results of a clinical randomized study
Laura Lladó
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorEmilio Ramos
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorCorresponding Author
Juan Figueras MD
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Liver Transplant Unit, Department of Surgery, CSU de Bellvitge, C/Feixa Llarga s/n, 08907, Barcelona, Spain. Telephone: 3493-260-7940; FAX: 3493-260-7603Search for more papers by this authorTeresa Serrano
Department of Pathology, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorJaume Torras
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAntoni Rafecas
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorJoan Fabregat
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorCarmen Lama
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorJuli Busquets
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAntonia Dalmau
Department of Anesthesiology, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAntonio Sabaté
Department of Anesthesiology, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorEduardo Jaurrieta
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorLaura Lladó
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorEmilio Ramos
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorCorresponding Author
Juan Figueras MD
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Liver Transplant Unit, Department of Surgery, CSU de Bellvitge, C/Feixa Llarga s/n, 08907, Barcelona, Spain. Telephone: 3493-260-7940; FAX: 3493-260-7603Search for more papers by this authorTeresa Serrano
Department of Pathology, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorJaume Torras
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAntoni Rafecas
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorJoan Fabregat
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorCarmen Lama
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorJuli Busquets
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAntonia Dalmau
Department of Anesthesiology, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAntonio Sabaté
Department of Anesthesiology, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorEduardo Jaurrieta
Department of Surgery, Liver Transplant Unit, Ciudad Sanitaria Universitaria (CSU) Bellvitge, University of Barcelona, Spain
Search for more papers by this authorAbstract
Aims of this study are to analyze the influence of endothelin-1 (ET-1) on hemodynamic evolution during liver transplantation (LT) and study the role of a temporary portacaval shunt in ET-1 synthesis. Forty LTs in patients with cirrhosis were studied. Two groups were analyzed: the first group had a temporary portacaval shunt during the anhepatic phase, and the second group did not. Portal and systemic ET-1 levels were measured at several times. At the end of the anhepatic phase, systemic (16.1 ± 6.5 pg/mL) and portal (19.2 ± 7 pg/mL) ET-1 levels increased, whereas they decreased after reperfusion (systemic, 11.8 ± 7.1 pg/mL; portal, 13.2 ± 6.8 pg/mL). Portal flow at the beginning of LT correlated with systemic ET-1 levels (R2 = 0.3; P = .004). A temporary portacaval shunt reduced portal pressure during the anhepatic phase, but did not modify ET-1 levels. Patients with reperfusion syndrome had greater systemic ET-1 levels in the anhepatic phase (19.1 ± 6.9 v 15.1 ± 6.1 pg/mL; P = .07). Although there is a relationship between ET-1 levels and portal flow and reperfusion syndrome, no clear clinical effect on hemodynamics could be shown. Creation of a portacaval shunt made no change in ET-1 levels.
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