The Correlation of Hemodynamic Changes and Early Allograft Function Following Liver Transplantation

The systemic circulation in patients with cirrhosis is hyperdynamic, marked by elevated cardiac output (CO) and heart rate (HR), coupled with significantly reduced systemic vascular resistance. This retrospective study aimed to evaluate the correlation between hemodynamic alterations and liver function through non-invasive hemodynamic monitoring during the early postoperative period in liver transplant recipients.

The medical records of patients who underwent living donor liver transplantation between February and December 2024 were reviewed. Liver function indices, including total bilirubin, prothrombin time-international normalized ratio (PT-INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and ammonia, were collected from the operative day to postoperative day 28. Hemodynamic indices, including CO, cardiac index (CI), HR, stroke volume (SV), SV index (SVI), SV variation (SVV), and thoracic fluid content (TFC), were collected during the initial six days post-transplantation.

Nineteen recipients were enrolled in the study. Levels of total bilirubin, PT-INR, AST, ALT, ammonia and LDH significantly decreased from postoperative day 1 to day 7 (p for trend: .049, < .001, < .001, < .001, < .001, and < .001, respectively). During the initial 132 hours post-transplantation, significant decreases were observed in CO, CI, HR, SV, and SVI (all p for trend < .001). In contrast, SVV and TFC levels increased during the same period (all p for trend < .001). Reductions in CO, CI, HR, SV, and SVI were significantly correlated with decreases in liver function indices (all p < .05). In contrast, the rise in SVV demonstrated a substantial correlation with diminished liver function indices (all p < .05).

These findings suggested that the recovery of hemodynamic stability may serve as a reliable indicator of a well-functioning liver graft.