Vasopressin decreases portal vein pressure and flow in the native liver during liver transplantation

Gebhard Wagener, Gina Gubitosa, John Renz, Milan Kinkhabwala, Tricia Brentjens, James V. Guarrera, Jean Emond, H. Thomas Lee, Donal Landry

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Vasodilation due to impaired vascular tone is common in liver failure. Vasoconstrictor drugs are almost always required during the anhepatic phase of a liver transplant to maintain blood pressure unless venovenous bypass is employed. Arginine-vasopressin can be used as a vasoconstrictor instead of or in addition to norepinephrine for this purpose, but the effect of vasopressin on the portal vein pressure and flow in this setting is unknown. Portal vein pressure, portal vein blood flow, hemodynamic variables, and plasma vasopressin levels were measured in 16 patients during liver transplantation after ligation of the hepatic artery before and after a vasopressin infusion of 3.8 ± 1.1 units/hour. Measurements were performed on the native liver prior to caval clamping. After vasopressin infusion, the portal vein pressure decreased significantly from 24.0 ± 6.5 to 21.5 ± 7.4 mm Hg [mean ± standard deviation (SD), P = 0.006]. The portal vein blood flow also decreased (from 1.01 ± 0.53 to 0.76 ± 0.53 L/minute, mean ± SD, P < 0.0001), as did the portal vein blood flow to cardiac output ratio (from 0.14 ± 0.06 to 0.10 ± 0.07, mean ± SD, P < 0.0001). In conclusion, vasopressin significantly decreased portal vein pressure and flow of the native liver without decreasing cardiac output or intestinal perfusion in patients undergoing liver transplantations.

Original languageEnglish (US)
Pages (from-to)1664-1670
Number of pages7
JournalLiver Transplantation
Volume14
Issue number11
DOIs
StatePublished - 2008
Externally publishedYes

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Portal Pressure
Portal Vein
Vasopressins
Liver Transplantation
Liver
Vasoconstrictor Agents
Cardiac Output
Venae Cavae
Arginine Vasopressin
Hepatic Artery
Liver Failure
Constriction
Vasodilation
Ligation
Blood Vessels
Norepinephrine
Perfusion
Hemodynamics
Blood Pressure
Transplants

ASJC Scopus subject areas

  • Surgery
  • Transplantation
  • Hepatology

Cite this

Wagener, G., Gubitosa, G., Renz, J., Kinkhabwala, M., Brentjens, T., Guarrera, J. V., ... Landry, D. (2008). Vasopressin decreases portal vein pressure and flow in the native liver during liver transplantation. Liver Transplantation, 14(11), 1664-1670. https://doi.org/10.1002/lt.21602

Vasopressin decreases portal vein pressure and flow in the native liver during liver transplantation. / Wagener, Gebhard; Gubitosa, Gina; Renz, John; Kinkhabwala, Milan; Brentjens, Tricia; Guarrera, James V.; Emond, Jean; Lee, H. Thomas; Landry, Donal.

In: Liver Transplantation, Vol. 14, No. 11, 2008, p. 1664-1670.

Research output: Contribution to journalArticle

Wagener, G, Gubitosa, G, Renz, J, Kinkhabwala, M, Brentjens, T, Guarrera, JV, Emond, J, Lee, HT & Landry, D 2008, 'Vasopressin decreases portal vein pressure and flow in the native liver during liver transplantation', Liver Transplantation, vol. 14, no. 11, pp. 1664-1670. https://doi.org/10.1002/lt.21602
Wagener, Gebhard ; Gubitosa, Gina ; Renz, John ; Kinkhabwala, Milan ; Brentjens, Tricia ; Guarrera, James V. ; Emond, Jean ; Lee, H. Thomas ; Landry, Donal. / Vasopressin decreases portal vein pressure and flow in the native liver during liver transplantation. In: Liver Transplantation. 2008 ; Vol. 14, No. 11. pp. 1664-1670.
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