Hemodynamic Changes and Early Recovery of Liver Graft Function after Liver Transplantation.

Abstract

Background: Patients with liver cirrhosis experience a hyperdynamic circulation.

Objective: To investigate the association between early hemodynamic changes and graft function after liver transplant.

Methods: Those patients who underwent liver transplantation in 2016 were enrolled in the study. Liver function indices measured in postoperative days (POD) 1, 3, 5, 7, 9, and 11 along with hemodynamic indices including pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and central venous pressure (CVP) measured q6h in the first 3 days after transplantation were recorded.

Results: 57 deceased-donor liver recipients with a mean±SD age of 41.4±11.8 years including 33 (58%) males were enrolled in the study. The mean±SD aspartate and alanine aminotransferases, alkaline phosphatase, and lactate dehydrogenase were significantly decreased from 1879±670.5, 369.2±40.5, 174.9±18.8, and 1907.6±323.1 U/L in POD 1 to 37.2±10.7, 243.4±37.3, 207.5±19.5, and 382.4±59.8 U/L in POD 3, respectively (p=0.028, <0.001, 0.002, and 0.001, respectively). During this period, the pulse rate of the patients was significantly (p<0.001) decreased by a median (IQR) of 28.7 (8.5-39.7) beats/min; it was significantly correlated with a decrease in serum hepatic enzymes activities during this period. SBP, DBP, and CVP were significantly increased (p<0.001 for all) during this period. Liver graft function improved significantly earlier in those patients with a mean pulse rate of 87 beats/min compared with others (p=0.03).

Conclusions: There may be an association between changes of hemodynamic indices, especially reduction of pulse rate, and improved graft function early after liver transplantation.