Assessment of cardiac output in liver transplantation recipients.

BACKGROUND

Liver cirrhosis causes peculiar systemic hemodynamics, and accurate evaluation of systemic hemodynamic state is important for cirrhotic recipients who underwent living donor liver transplantation (LDLT). We investigated the clinical advantages of a novel non-invasive method for measuring systemic hemodynamic parameters using indocyanine green (ICG).

METHODS

Twenty-eight LDLT recipients were evaluated. Simultaneous measurements of cardiac output (CO) using Swan-Ganz catheters and pulse dye densitometry (PDD) were performed every 12 hours after LDLT. A total of 155 sets of simultaneous CO measurements were obtained.

RESULTS

The CO values obtained by PDD correlated well with those obtained by the invasive catheter technique. In addition, none of the recipients developed any side-effects, and we verified the safety of repeated ICG injections. ICG is safe, even for repeated use over time in the same recipient. Moreover, PDD can measure the blood volume (BV).

CONCLUSIONS

Since the cirrhotic systemic hemodynamics characterized by high CO and large BV remains, even after LDLT, the ability to measure CO and BV in a non-invasive, simple and real-time manner using PDD has advantages for cirrhotic LDLT recipients.