Table of Contents
ISRN Transplantation
Volume 2014, Article ID 757910, 5 pages
http://dx.doi.org/10.1155/2014/757910
Clinical Study

A Hemodynamic Study to Evaluate the Buffer Response in Cirrhotic Patients Undergoing Liver Transplantation

1Programa de Transplante Hepático, Unidad de Transplante, Hospital Alemán, Avenida Pueyrredón 1640, C1118AAT Buenos Aires, Argentina
2Servicio de Ecografía, Fundación Favaloro, Buenos Aires, Argentina

Received 19 January 2014; Accepted 18 February 2014; Published 18 March 2014

Academic Editors: N. De Ruvo and I. Popescu

Copyright © 2014 Margarita Anders et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The physiological regulation of the liver blood flow is a result of a reciprocal portal vein and hepatic artery flow relationship. This mechanism is defined as the hepatic arterial buffer response (HABR). This study was addressed to investigate whether HABR is maintained in denervated grafts in liver transplant recipients. Portal blood flow (PBF) and hepatic arterial resistance index (PI) were measured 6 months after transplantation using Doppler. In each patient we consecutively measured the vasodilator (Ensure Plus PO versus placebo) and vasoconstrictor (isosorbide dinitrate 5 mg SL versus placebo) stimuli. The meal ingestion caused a significant increase of both parameters, PBF (from to  mL/min, ) and PI (from to , ). By contrast, isosorbide dinitrate reduced PBF (from to  mL/min, ) and PI (from to , ). We show that PBF and PI are reciprocally modified with the administration of vasoconstrictor and vasodilator stimuli. These results suggest the persistence of the HABR in a denervated human model, suggesting that this mechanism is independent of the regulation from the autonomic nervous system.