Purpose of the measurement of intraoperative hepatic hemodynamics in liver transplant surgery

Abstract

Liver graft function depends on different biological factors that are related to the donor, the recipient and the potential damage arising from the organ preservation technique. However, adequate hepatic artery flow and portal vein flow rates ensure a sufficient flow of oxygen and nutrients in order to ensure a suitable cellular graft function after the extreme metabolic decrease condition induced by hypothermia and the preservation solution. Liver inflow is a highly complex system due to its double irrigation system. These two systems are connected by the well-known “hepatic arterial buffer response” concept. This mechanism explains changes in hepatic arterial flow (HAF) as a compensation for changes in the portal vein flow (PVF), so that the hepatic artery adjusts total flow in relation to alterations in the portal blood flow. At the moment, the minimum HAF and PVF required for an adequate regeneration and functional recovery of the liver graft have not been yet established.