ダウンロード数: 315
このアイテムのファイル:
ファイル | 記述 | サイズ | フォーマット | |
---|---|---|---|---|
wjh.v8.i25.1047.pdf | 1.23 MB | Adobe PDF | 見る/開く |
タイトル: | Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation |
著者: | Hori, Tomohide Ogura, Yasuhiro Onishi, Yasuharu Kamei, Hideya Kurata, Nobuhiko Kainuma, Motoshi Takahashi, Hideo Suzuki, Shogo Ichikawa, Takashi Mizuno, Shoko Aoyama, Tadashi Ishida, Yuki Hirai, Takahiro Hayashi, Tomoko Hasegawa, Kazuko Takeichi, Hiromu Ota, Atsunobu Kodera, Yasuhiro Sugimoto, Hiroyuki Iida, Taku Yagi, Shintaro https://orcid.org/0000-0001-7465-5761 (unconfirmed) Taniguchi, Kentaro Uemoto, Shinji |
著者名の別形: | 飯田, 拓 八木, 真太郎 上本, 伸二 |
キーワード: | Liver cirrhosis Portal hypertension Liver transplantation Indocyanine green Hyperdynamic |
発行日: | 1-Sep-2016 |
出版者: | Baishideng Publishing Group Co |
誌名: | World Journal of Hepatology |
巻: | 8 |
号: | 25 |
開始ページ: | 1047 |
終了ページ: | 1060 |
抄録: | 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. |
著作権等: | © The author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. Articles published by this open-access journal are distributed under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC 4.0) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. |
URI: | http://hdl.handle.net/2433/227081 |
DOI(出版社版): | 10.4254/wjh.v8.i25.1047 |
PubMed ID: | 27660671 |
出現コレクション: | 学術雑誌掲載論文等 |
このリポジトリに保管されているアイテムはすべて著作権により保護されています。