Functional changes of the heart and lung in perioperative period of orthotopic liver transplantation

Objective: To investigate the variation of functions ofthe heart and lung during orthotopic liver transplan-tation (OLT).Methods: Pulmonary artery cannula and right radialartery cannula were indewelled before anaesthesiaand the parameters of hemodynamics in different pe-riods were monitored. Analysis of variance was usedto reveal the variation among the groups. T hypothe-sis test in paired data was used to compare the preop-erative parameters with those in each period duringoperation and after operation respectively, and tocompare the parameters immediately after operationwith those in each period after operation respective-ly.Results: During the operation, heart rate increased,but blood pressure decreased significantly at the be-ginning of no-liver period, increased again in a shortperiod and then increased progressively 12 h after op-eration. Pulmonary artery pressure (PAP) increasedfrom before the no-liver period to 60 h after opera-tion. Pulmonary wedge pressure changed in accord-ance with the variation of PAP. Cardiac output wasmaintained at a high-output level from before opera-tion to 60 h after operation. Systemic vascular resist-ance (SVR) was within the normal limits before op-eration, whereas pulmonary vascular resistance(PVR) was lower than normal. In the no-liver peri-od during the operation, SVR decreased significant-ly. Both SVR and PVR increased progressively andreturned to normal postoperatively.Conclusions: The patients undergoing OLT have ahigh cardiac output and Iow resistance obstacle be-fore and during the operation, and will recover grad-ually after operation. Monitoring hemodynamicsduring the peri-operative period is of significance inthe prevention and treatment of pneumonedema andcardiac functional insufficiency.