Chen Xiping, Xiao Huan, Yang Chunjiang, Chen Jingyu, Gao Yang, Tang Yi, Ji Xiaojuan
Department of Ultrasound, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Ultrasound, Chongqing General Hospital, Chongqing, China.
Front Bioeng Biotechnol. 2022 Aug 11;10:903385. doi: 10.3389/fbioe.2022.903385. eCollection 2022.
The aim of this study was to explore the hemodynamic changes of hepatic artery and portal vein detected by Doppler ultrasound (DU) in infants who underwent living donor liver transplantation (LDLT). The data of 41 infant patients (22 Males, 19 Females, median age of 5 months) were collected in the Children's Hospital affiliated to the Chongqing Medical University from May 2018 to December 2019. The patients underwent left lateral segment LDLT (LLS -LDLT) because of biliary atresia (BA). Hemodynamic parameters, including the peak systolic velocity (PSV), resistivity index (RI) of the hepatic artery (HA), portal vein velocity (PVV), and portal vein flow (PVF) were recorded from Doppler ultrasound on the day before the operation, and on the 1st, the 7th, the 14th and the 30th day after LDLT procedures. The changes of PSV, RI, PVV and PVF before and on the 1st day after transplantation were analyzed by paired -test. The comparison of the data between different postoperative time points were assessed by ANOVA. Compared with the parameters measured before LDLT, PSV, and RI decreased, and PVV and PVF increased significantly ( < 0.001) on the 1st day after LLS-LDLT. As for PSV, there was no significant difference between the 7th day and the 1st day after transplantation (POD7 POD1, = 0.167) while there was a substantial difference between the 14th, 30th and 1st day after LT (POD14 vs POD1, = 0.003) (POD30 vs POD1, < 0.001). And there was a significant difference between the 14th, 30th, and 7th days after LT (POD14 vs POD7, = 0.014) (POD30 vs POD7, < 0.001). There was no significant difference between 30th and 14th after transplantation (POD30 vs POD14, = 0.092). As for RI and PVV, the decrease was slow within the first month after the operation, and there was no significant difference at different times. We have identified major hepatic flow changes that occurred in 41 infants who underwent LLS -LDLT due to BA. The data could be used for future studies of LDLT in infants including hemodynamic modeling, liver regeneration and clinical management.
本研究旨在探讨经多普勒超声（DU）检测的活体肝移植（LDLT）婴儿肝动脉和门静脉的血流动力学变化。2018年5月至2019年12月，重庆医科大学附属儿童医院收集了41例婴儿患者（男22例，女19例，中位年龄5个月）的数据。这些患者因胆道闭锁（BA）接受了左外叶LDLT（LLS-LDLT）。在手术前一天以及LLS-LDLT术后第1天、第7天、第14天和第30天，通过多普勒超声记录血流动力学参数，包括肝动脉（HA）的收缩期峰值速度（PSV）、阻力指数（RI）、门静脉速度（PVV）和门静脉血流（PVF）。采用配对检验分析移植前及移植后第1天PSV、RI、PVV和PVF的变化。采用方差分析评估术后不同时间点的数据差异。与LLS-LDLT术前测量的参数相比，术后第1天PSV和RI降低，PVV和PVF显著升高（<0.001）。至于PSV，移植后第7天与第1天之间无显著差异（POD7对POD1，=0.167），而肝移植后第14天、第30天与第1天之间存在显著差异（POD14对POD1，=0.003）（POD30对POD1，<0.001）。肝移植后第14天、第30天与第7天之间存在显著差异（POD14对POD7，=0.014）（POD30对POD7，<0.001）。移植后第30天与第14天之间无显著差异（POD30对POD14，=0.092）。至于RI和PVV，术后第一个月内下降缓慢，不同时间无显著差异。我们已经确定了41例因BA接受LLS-LDLT的婴儿发生的主要肝血流变化。这些数据可用于未来婴儿LDLT的研究，包括血流动力学建模、肝再生和临床管理。
