Confrontation between portal pressure and wedged hepatic venous pressure after liver transplantation

Abstract

Introduction: portal pressure (PP) after liver transplantation (LTx) has often been evaluated using the hepatic venous pressure (WHVP). However, the agreement between PP and WHVP has not been investigated in the transplanted liver. Patients and Methods: Twenty-three LTx recipients were prospectively studied. PP was measured through ileal vein cannulation. WHVP and hepatic venous pressure (HVP) were measured using a balloon catheter. Pressure gradients were compared using paired Student's t-test and linear regression analysis. Results: There is a significant gradient between PP and WHVP (1.4 ± 1.6mmHg; p<0.001). A gradient of 2mmHg or more was observed in 9 cases (39.1 %). PP and
WHVP are linearly related (WHVP=1.397+0.845*PP; r=0.938; p<0.001) as well as PP-WHVP and PP-HVP gradients (PPWHVP=-0.871+0.429*PP-HVP; r=0.429; p=0.001). Conclusion: 1) Despite a strong linear correlation, there is a significant gradient between PP and WHVP in the transplanted liver; 2) The gradient is more pronounced in cases with higher portal pressure.