Treatment for pulmonary artery hypertension in liver transplantation / 中国组织工程研究

ABSTRACT

BACKGROUND: Serious lesion to liver function may cause the pulmonary artery hypertension and fluctuation of haemodynamics directly induces changes of pulmonary artery pressure during neo-hepatic stage in liver transplantation. OBJECTIVE: To observe the change of pulmonary artery pressure during liver transplantation and to explore treatment for pulmonary artery hypertension. DESIGN, TIME AND SETTING: Controlled observation was carried out among the liver transplant recipients who were enrolled from the 181 Hospital of Chinese PLA from June 2004 to June 2006. PARTICIPANTS: Totally 13 patients, all males, were reviewed. Their ages ranged from 19 to 53 years. They were selective for the liver transplantation. METHODS: Undergoing general anesthesia, mean arterial blood pressure, central venous pressure, pulmonary arterial pressure and pulmonary arterial wedge pressure were continuously monitored by Swan-Ganz catheter method and reversible Fick’s law continuous monitoring. Available respiration administration, low dose of glyceryltrinitrate (0.1-5.0 ?g/kg/min) and Alprostadil (1.0-2.0 ?g) were administered to diminish elevated pulmonary arterial pressure and pulmonary arterial wedge pressure during the period after unclamping portal vein in liver transplantation. MAIN OUTCOME MEASURES: Changes of mean arterial blood pressure and pulmonary arterial pressure. RESULTS: The mean arterial blood pressure deceased at the time of unclamping portal vein in all 13 patients, pulmonary arterial pressure and pulmonary arterial wedge pressure both increased significantly at 5 and 15 minutes within neo-hepatic stage, which were more obvious than those during anhepatic stage in 13 patients (P