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| 1 | Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation显示文摘Advanced liver cirrhosis is usually accompanied by portal hypertension. Long-term portal hypertension results in various vascular alterations. The systemic hemodynamic state in patients with cirrhosis is termed a hyperdynamic state. This peculiar hemodynamic state is characterized by an expanded blood volume, high cardiac output, and low total peripheral resistance. Vascular alterations do not disappear even long after liver transplantation(LT), and recipients with cirrhosis exhibit a persistent systemic hyperdynamic state even after LT. Stability of optimal systemic hemodynamics is indispensable for adequate portal venous flow(PVF) and successful LT, and reliable parameters for optimal systemic hemodynamics and adequate PVF are required. Even a subtle disorder in systemic hemodynamics is precisely indicated by the balance between cardiac output and blood volume. The indocyanine green(ICG) kinetics reflect the patient's functional hepatocytes and effective PVF, and PVF is a major determinant of the ICG elimination constant(kICG) in the well-preserved allograft. The kICG value is useful to set the optimal PVF during living-donor LT and to evaluate adequate PVF after LT. Perioperative management has a large influence on the postoperative course and outcome; therefore, key points and unexpected pitfalls for intensive management are herein summarized. Transplant physicians should fully understand the peculiar systemic hemodynamic behavior in LT recipients with cirrhosis and recognize the critical importance of PVF after LT. | Tomohide Hori Yasuhiro Ogura Yasuharu Onishi Hideya Kamei Nobuhiko Kurata Motoshi Kainuma Hideo Takahashi Shogo Suzuki Takashi Ichikawa Shoko Mizuno Tadashi Aoyama Yuki Ishida Takahiro Hirai Tomoko Hayashi Kazuko Hasegawa Hiromu Takeichi Atsunobu Ota Yasuhiro Kodera Hiroyuki Sugimoto Taku Iida Shintaro Yagi Kentaro Taniguchi Shinji Uemoto | 2016 | World Journal of Hepatology2016,8,25: | 3 |
| 2 | Assessment of cardiac output in liver transplantation recipients显示文摘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 hemody- namics 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. | Tomohide Hori Chiduru Yamamoto Shintaro Yagi Taku Iida Kentaro Taniguchi Takashi Hasegawa Koichiro Yamakado Yukinobu Hori Kan Takeda Kazuo Maruyama Shinji Uemoto | 2008 | Hepatobiliary & Pancreatic Diseases International2008,7,4: | 2 |
| 3 | 门脉右支流速预测肝硬化发生的诊断价值初探显示文摘目的探讨超声检查中门脉右支流速对于预测肝硬化发生的诊断价值。方法对120例慢性肝病患者行超声检查,其中30例为慢性肝炎患者,90例为肝硬化患者,记录其门脉右支流速值,并绘制相应的工作特征曲线,计算曲线下面积(AUC),评价其对肝硬化的诊断价值。结果门脉右支流速诊断肝硬化的AUC为0.702(可信区间为0.602~0.802),根据ROC曲线选定的最佳分界点(cut-off)值为15.5 kPa(P〈0.0001)。灵敏度为71.10%,特异度为68%,约登指数0.37。结论门脉右支流速对预测肝硬化发生具有较高的诊断价值。 | 王奇 王俐琼 张玮 | 2015 | 肝脏2015,20,7: | 1 |
| 4 | 门静脉右支流速对肝硬化诊断价值比较研究显示文摘目的探讨超声检查中门静脉右支流速预测肝硬化发生的诊断价值。方法对452例慢性肝病患者行超声检查,记录脾脏长度、脾脏厚度、门静脉宽度、门静脉右支流速值,并绘制相应的受试者工作特征曲线(ROC),计算曲线下面积(AUC),依据不同肝硬化程度进行分层分析。结果门静脉右支流速诊断肝硬化的AUC为0.720(可信区间为0.655~0.698),根据ROC曲线选定的最佳分界点(cut-off)值为15.3 kPa(P<0.0001)。灵敏度为73.08%,特异度为69%,约登指数0.36。结论门静脉右支流速对预测肝硬化发生具有较高的诊断价值,随着肝硬化程度加重,门静脉右支流速随之降低。 | 王俐琼 王奇 张玮 | 2017 | 肝脏2017,22,5: | 1 |
| 5 | CT灌注成像评估活体肝移植术后肝脏血液动力学变化显示文摘目的:探讨CT灌注成像技术在评估活体肝移植术后肝脏血液动力学变化中的临床应用价值。方法:35例右叶活体肝移植供体,30例右叶活体肝移植术后无SFSS受体及6例伴SFSS受体患者均行肝脏CT灌注成像,测量各组活体肝移植术前供体及术后14天和28天受体肝总血流量(TBF)、肝动脉灌注量(HAP)及门静脉灌注量(PVP)。分析和各组之间灌注参数的差异及相关性。结果:与正常供体捐赠前[(PVP0=(82.5±13.0)ml/(min.100g)]相比,无SFSS受体的患者在术后14天和28天时PVP明显增高[PVP14=(139.7±40)ml/(min.100g),PVP28=(109.8±19)ml/(min.100g)],差异有极显著性意义(P<0.001和P=0.008),但术后28天PVP较术后14天明显降低(P=0.007)。SFSS组术后14天PVP较无SFSS组明显增高[PVP14=(186.0±22.0)ml/(min.100g)],差异有显著性意义(P=0.042)。结论:CT灌注成像能准确评价无SFSS供体血流动力学改变。 | 秦玲娣 庄治国 钱黎俊 汪笔雄 王文晶 周滟 夏强 许建荣 | 2009 | 放射学实践2009,24,11: | 1 |