Almost all adult recipients who undergo LDLT develop liver cirrhosis with long-term portal hypertension. Portal hypertension results in vascular dilatation and collateral pathways. Thus, various alterations in systemic hemodynamics and splanchnic circulation occur, and adult recipients often present characteristic hemodynamics before LDLT. A research group from Kyoto University Hospital, Japan (Hori T, Yagi S, Iida T, Uemoto S), non-invasively investigated systemic hemodynamics and splanchnic circulation after LDLT in 30 adult recipients with liver cirrhosis who underwent LDLT (2003-2006), and their research has been published on the November issue 28 of World Journal of Gastroenterology. The article ascertained the correlation between systemic hemodynamics and splanchnic circulation, and clarified how systemic hemodynamic state impacts on local graft circulation. Interestingly, the results of splanchnic circulatory parameters in their current study reveal systemic hemodynamics correlate well with splanchnic circulation, and that subtle disorders of optimal systemic hyperdynamic state easily influence portal venous flow rather than hepatic arterial flow. Moreover, they also identify what hemodynamic state is necessary for excellent clinical outcomes corresponding to good graft functions. Dr. Hori demonstrated the persistence of characteristic systemic hyperdynamic state is indispensable for cirrhotic recipients, even after LDLT, by using a device that can non-invasively analyze the kinetics of indocyanine green, and he is doing further study now at Kyoto University Hospital. Since portal venous flow has been shown to have a large influence on liver regeneration after LDLT, successful clinical outcomes in cirrhotic LDLT recipients are attributed to optimal stability of systemic hyperdynamic state yielding sufficient portal venous flow.
Reference: Hori T, Yagi S, Iida T, Taniguchi K, Yamagiwa K, Yamamoto C, Hasegawa T, Yamakado K, Kato T, Saito K, Wang L, Torii M, Hori Y, Takeda K, Maruyama K, Uemoto S. Stability of cirrhotic systemic hemodynamics ensures sufficient splanchnic blood fl ow after living-donor liver transplantation in adult recipients with liver cirrhosis. World J Gastroenterol 2007; 13(44): 5918-5925 http://www.wjgnet.com/1007-9327/13/5918.asp
Correspondence to: Tomohide Hori, M.D., Ph.D., Department of Transplantation, Divisions of Hepato-pancreato-biliary Surgery and Transplantation and Pediatric Surgery, Kyoto University Hospital, 54 Shogoinkawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. horit@kuhp.kyoto-u.ac.jp Telephone: +81-75-7513651 Fax: +81-75-7513106
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by The WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology