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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Hemodynamics and vasoactive substance levels during renal congestion that occurs in the anhepatic phase of liver transplantation
Zhong-Xin Li, Man-Cai Wang, You-Cheng Zhang, Jie Mao, Mo Chen, Rui Ni, Feng-Xian Wei, Gen-Nian Wang, Ling-Yi Zhang
Zhong-Xin Li, Man-Cai Wang, Mo Chen, Rui Ni, Feng-Xian Wei, Gen-Nian Wang, Ling-Yi Zhang, Department of Hepatology, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Zhong-Xin Li, Man-Cai Wang, You-Cheng Zhang, Jie Mao, Mo Chen, Rui Ni, Feng-Xian Wei, Gen-Nian Wang, Ling-Yi Zhang, Hepato-Biliary-Pancreatic Institute, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Man-Cai Wang, You-Cheng Zhang, Jie Mao, Mo Chen, Rui Ni, Feng-Xian Wei, Gen-Nian Wang, Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Author contributions: Zhang LY, Zhang YC and Li ZX designed the research; Li ZX, Wang MC, Mao J, Chen M, Ni R, Wang GN and Wei FX performed the research; Ni R and Wang GN contributed new reagents/analytic tools; Zhang YC and Mao J analyzed the data; Wang MC and Li ZX wrote the paper.
Supported by Natural Science Foundation of Gansu Province, China, No. 3ZS051-A25-104; Clinical Medicine Research Special Funds of Chinese Medical Association, China, No.14040360573.
Ethics approval: The study was approved by the Ethics Committee of the Lanzhou University Second Hospital.
Institutional animal care and use committee: All procedures involving animals were reviewed and approved by the Institutional Animal Care and Use Committee of the Lanzhou University [SCXK (gan) 2009-0004; SYXK (gan) 2009-0004].
Conflict-of-interest: There are no potential conflicts of interest relevant to this article to report.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ling-Yi Zhang, MD, Department of Hepatology, Lanzhou University Second Hospital, Cuiyingmen 82, Chengguan District, Lanzhou 730030, Gansu Province, China. zhanglymd@126.com
Telephone: +86-93-18453109 Fax: +86-93-18453109
Received: November 26, 2014
Peer-review started: November 26, 2014
First decision: December 26, 2014
Revised: January 22, 2015
Accepted: February 12, 2015
Article in press: February 13, 2015
Published online: May 14, 2015
AIM: To explore hemodynamics and vasoactive substance levels during renal vein congestion that occurs in the anhepatic phase of liver transplantation.
METHODS: New Zealand rabbits received ligation of the hepatic pedicle, supra-hepatic vena cava and infra-hepatic vena cava [anhepatic phase group (APH); n = 8], the renal veins (RVL; n = 8), renal veins and hepatic pedicle [with the inferior vena cava left open) (RVHP; n = 8)], or a sham operation (SOP; n = 8). Hemodynamic parameters (systolic, diastolic, and mean arterial blood pressures) and the levels of serum bradykinin (BK) and angiotensin II (ANGII) were measured at baseline (0 min), and 10 min, 20 min, 30 min, and 45 min after the surgery. Correlation analyses were performed to evaluate the associations between hemodynamic parameters and levels of vasoactive substances.
RESULTS: All experimental groups (APH, RVL, and RVHP) showed significant decreases in hemodynamic parameters (systolic, diastolic, and mean arterial blood pressures) compared to baseline levels, as well as compared to the SOP controls (P < 0.05 for all). In contrast, BK levels were significantly increased compared to baseline in the APH, RVL, and RVHP groups at all time points measured (P < 0.05 for all), whereas no change was observed in the SOP controls. There were no significant differences among the experimental groups for any measure at any time point. Further analyses revealed that systolic, diastolic, and mean arterial blood pressures were all negatively correlated with BK levels, and positively correlated with ANGII levels in the APH, RVL, and RVHP groups (P < 0.05 for all).
CONCLUSION: In the anhepatic phase of orthotopic liver transplantation, renal vein congestion significantly impacts hemodynamic parameters, which correlate with serum BK and ANGII levels.
Core tip: Hemodynamic disorders remain a focus of concern in the anhepatic phase of orthotopic liver transplantation as they contribute to procedural morbidity and mortality. This study shows that various procedures that cause renal vein congestion significantly reduce hemodynamic measures, which correlate with reduced angiotensin II and increased bradykinin levels in serum.
