Chang C-D, Cheng Y-F, Chen T-Y, Tsang L L-C, Ou H-Y, Yu C-Y, Hsu H-W, Chen C-L, Concejero A M, Huang T-L
Liver Transplantation Program and Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Transplant Proc. 2014 Apr;46(3):696-8. doi: 10.1016/j.transproceed.2013.11.142.
The relationship between portal pressure and small-for-size syndrome (SFSS) is unsettled. The purpose of this study was to evaluate the role of portal pressure in predicting SFSS.
Thirty-four patients with end-stage liver disease who received adult-to-adult living-donor liver transplantation (ALDLT) were included. Recipients were grouped based on whether they received portal flow modulation or not. The intraoperative portal vein flow volume (PVFV) and portal venous pressure (PVP) between the 2 groups were compared. The relationship of PVP to PVFV, graft weight-to-recipient weight ratio (GRWR), and graft weight-to-recipient spleen size ratio (GRSSR) were analyzed.
Persistent portal hypertension was found after ALDLT. The PVP was linearly correlated with PVFV but not with GRWR or GRSSR. With the use of the following criteria, (1) PVFV >250 mL/min/100 g graft weight, (2) GRWR <0.8%, and (3) GRSSR <0.6, modulation of the portal flow was performed in 3 cases. The receiver operating characteristic analysis showed that 23 mm Hg was the cutoff point for PVP, with a sensitivity of 83% and specificity of 43%.
PVP is a weak parameter to use for portal flow modulation after ALDLT. It is sensitive but not specific to predict SFSS.
门静脉压力与小肝综合征（SFSS）之间的关系尚无定论。本研究的目的是评估门静脉压力在预测SFSS中的作用。
纳入34例接受成人对成人活体肝移植（ALDLT）的终末期肝病患者。根据接受门静脉血流调节与否对受者进行分组。比较两组术中门静脉血流量（PVFV）和门静脉压力（PVP）。分析PVP与PVFV、移植物重量与受者体重比（GRWR）以及移植物重量与受者脾脏大小比（GRSSR）之间的关系。
ALDLT术后发现持续性门静脉高压。PVP与PVFV呈线性相关，但与GRWR或GRSSR无关。采用以下标准：（1）PVFV>250 mL/min/100 g移植物重量，（2）GRWR<0.8%，（3）GRSSR<0.6，对3例患者进行了门静脉血流调节。受试者工作特征分析显示，PVP的截断点为23 mmHg，灵敏度为83%，特异度为43%。
PVP是ALDLT后门静脉血流调节的一个较弱参数。它对预测SFSS敏感但不特异。
