ProgramsView all programs
From the news
- Chancellor Amma Addresses the Parliament of World’s Religions
- Amrita Students Qualify for the European Mars Rover Challenge
Publication Type : Journal Article
Thematic Areas : Medical Sciences
Publisher : J Clin Exp Hepatol
Source : J Clin Exp Hepatol, Volume 7, Issue 3, p.235-246 (2017)
Campus : Kochi
School : School of Medicine
Department : Gastrointestinal Surgery
Year : 2017
Abstract : BACKGROUND: Portal hyperperfusion as a cause of small for size syndrome (SFSS) after living donor liver transplantation (LDLT) remains controversial. Portal venous pressure (PVP) is often measured indirectly and may be confounded by central venous pressure (CVP).METHODS: In 42 adult cirrhotics undergoing elective LDLT, PVP was measured by direct canulation of portal vein and porto systemic gradient (PSG) was obtained after subtracting CVP from PVP. None underwent portal inflow modulation. SFSS was looked in 27 patients after excluding 15 with technical complications.
RESULTS: Clinical features of SFSS found in 6 patients, 5 with graft recipient weight ratio (GRWR) > 0.8% and PVP < 20 mm of Hg. One with GRWR < 0.8% could truly be labeled as SFSS. Incidence of SFSS was not higher in patients with elevated PVP > 20 mm of Hg (14.3% vs 0%, = 0.259) or PSG > 13 mm of Hg (33.3% vs 0%, = 0.111). Intensive care unit (ICU) stay was longer in patients with elevated PVP (14.55 vs 9.13 days, = 0.007) and PSG (16.8 vs 9.72 days, = 0.009). There was no difference in graft functions, post-operative complications and mortality in first month post-LDLT.CONCLUSION: Elevated PVP or PSG increased morbidity but neither predicted SFSS nor affected survival.
Cite this Research Publication : A. Vijay Kanetkar, Dinesh Balakrishnan, Sudhindran, S., Dhar, P., Gopalakrishnan, U., Menon, R., and Sudheer, O. Vayoth, “Is Portal Venous Pressure or Porto-systemic Gradient Really A Harbinger of Poor Outcomes After Living Donor Liver Transplantation?”, J Clin Exp Hepatol, vol. 7, no. 3, pp. 235-246, 2017.