Changes of pulmonary hemodynamics in peri-operative period of orthotopic liver transplantation in patients with chronic hepatic disease

Objective To investigate the pulmonary hemodynamic changes during orthotopic liver transplantation(OLT).Methods The parameters of hemodynamics were monitored through Swan-Ganz catheter and radial artery canula in different period and were compared with the preoperative ones.Results Heart rate accelerated at the beginning of no-liver period.Blood pressure decreased significantly at the early reperfusion stages and then elevated progressively 12 hours after operation. Pulmonary arterial pressure(PAP) began increasing at the early reperfusion stages,further increased 48 hours after operation. Pulmonary artery wedge pressure changed in accordance with PAP.Cardiac output was at high-output level preoperatively,then reduced significantly during veno-venous bypass,recovered gradually 48 hours after operation.SVR increased significantly during veno-venous bypass, recovered at the reperfusion stage, reached the level of preoperatively after 48 hours after operation.Pulmonary vascular resistance was below normal level and didn't change during the operation,then increased progressively postoperatively.Conclusions It is valuable to monitoring the pulmonary blood flow changes during perioperative period of OLT to prevent and manage pneumonedema and cardiac insufficiency.