Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Feb 7, 2010; 16(5): 608-612
Published online Feb 7, 2010. doi: 10.3748/wjg.v16.i5.608
Hemodynamics in the immediate post-transplantation period in alcoholic and viral cirrhosis
Waleed K Al-Hamoudi, Saleh Alqahtani, Puneeta Tandon, Mang Ma, Samuel S Lee
Waleed K Al-Hamoudi, Gastroenterology Unit (59), College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia
Saleh Alqahtani, Gastroenterology unit, King Faisal Specialist Hospital & Research Center, Jeddah 21499, Saudi Arabia
Puneeta Tandon, Mang Ma, Alberta Liver Transplantation Program, University of Alberta, Edmonton, Alberta, T6G 2X8, Canada
Samuel S Lee, Liver Unit, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
Author contributions: Ma M designed the study; Al-Hamoudi WK wrote the manuscript; Alqahtani S, Tandon P and Al-Hamoudi WK conducted data collection; Al-Hamoudi WK, Ma M and Lee SS conducted data interpretation; all authors conducted manuscript revisions and final approval.
Supported by Research grants from the Canadian Liver Foundation
Correspondence to: Dr. Waleed K Al-Hamoudi, Gastroenterology Unit (59), College of Medicine, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia. walhamoudi@gmail.com
Telephone: +966-1-4671215 Fax: +966-1-4671217
Received: October 17, 2009
Revised: December 7, 2009
Accepted: December 14, 2009
Published online: February 7, 2010
Abstract

AIM: To study the hemodynamics in the immediate post transplant period and compare patients with alcoholic vs viral cirrhosis.

METHODS: Between 2000-2003, 38 patients were transplanted for alcoholic cirrhosis and 28 for postviral cirrhosis. Heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), pulmonary capillary wedge pressure (PCWP), cardiac index (CI), systemic vascular resistance index (SVRI), pulmonary artery pressure (PAP), and pulmonary vascular resistance index (PVRI) were measured immediately and 24 h post transplantation.

RESULTS: Hyperdynamic circulation persisted at 24 h following transplantation with an elevated CI of 5.4 ± 1.3 L/(min × m2) and 4.9 ± 1.0 L/(min × m2) in the viral and alcoholic groups, respectively, and was associated with a decreased SVRI. Within the first 24 h, there was a significant decrease in HR and increase in MAP; the extent of the change was similar in both groups. The CVP, PCWP, and SVRI increased, and CI decreased in the viral patients, but not the alcoholic patients. Alcoholics showed a lower PVRI (119 ± 52 dynes/(cm5× m2) vs 166 ± 110 dynes/(cm5× m2), P < 0.05) and PAP (20 ± 7 mmHg vs 24 ± 7 mmHg, P < 0.05) compared to the viral group at 24 h.

CONCLUSION: Hyperdynamic circulation persists in the immediate post-transplant period with a faster improvement in the viral group. Alcoholic patients have a more pronounced pulmonary vasodilatation.

Keywords: Hemodynamics; Cirrhosis; Alcohol; Viral; Allograft