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Decreased splanchnic oxygen uptake and increased systemic oxygen uptake in cirrhosis are normalized after liver transplantation.
Liver Transpl. 2001 Dec; 7(12):1015-22.LT

Abstract

The aim of this study is to (1) characterize the impact of orthotopic liver transplantation (OLT) on splanchnic and systemic oxygen uptake (VO(2)) in patients with liver cirrhosis, and (2) investigate possible influencing factors, as well as metabolic consequences, of reduced splanchnic VO(2) in patients with cirrhosis. Therefore, we measured systemic VO(2) (indirect calorimetry), portal pressure (hepatic venous pressure gradient), hepatic blood flow (HBF; primed continuous infusion of indocyanine green), and hepatic turnover (arteriohepatic venous concentration differences multiplied by HBF) of oxygen, glucose, free fatty acids (FFAs), and aromatic amino acids (AAAs) in 52 patients with advanced cirrhosis and 16 patients with a clinically stable long-term course after OLT. Systemic VO(2) was significantly increased in patients with cirrhosis (261 +/- 7 mL/min) and normalized after OLT (216 +/- 8 mL/min; P < .001). Arterial and hepatic venous oxygen saturation and splanchnic oxygen extraction (in percent) were not different between patients with cirrhosis and after OLT. Splanchnic VO(2) was decreased in patients with cirrhosis (41 +/- 3 mL/min, representing 16% +/- 1% of systemic VO(2)) and normalized after OLT (69 +/- 6 mL/min; P < .001, representing 32% +/- 3% of systemic VO(2); P < .001). In patients with cirrhosis, a decrease in HBF was associated with decreased splanchnic VO(2) (r = 0.74; P < .001). Conversely, decreased splanchnic VO(2) reflected a decrease in hepatic glucose production (r = 0.34; P = .01) and hepatic extraction of FFAs (r = 0.40; P < .01) and AAAs (r = 0.30; P < .05). These results show that (1) splanchnic and systemic VO(2) normalize after OLT, indicating correction of hepatic and extrahepatic metabolic derangements; (2) in cirrhosis, HBF becomes limiting for hepatic oxygen supply; and (3) impaired splanchnic VO(2) reflects a decrease in metabolic liver function.

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Authors+Show Affiliations

Tietge UJ
Department of Gastroenterology and Hepatology, Hannover Medical School, Hannover, Germany.
Bahr MJ
No affiliation info available
Manns MP
No affiliation info available
Böker KH
No affiliation info available

MeSH

AdultFemaleHemodynamicsHumansLiverLiver CirculationLiver CirrhosisLiver TransplantationMaleMiddle AgedOxygenOxygen ConsumptionPostoperative PeriodReference ValuesSplanchnic Circulation

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11753903

Citation

Tietge, U J., et al. "Decreased Splanchnic Oxygen Uptake and Increased Systemic Oxygen Uptake in Cirrhosis Are Normalized After Liver Transplantation." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 7, no. 12, 2001, pp. 1015-22.
Tietge UJ, Bahr MJ, Manns MP, et al. Decreased splanchnic oxygen uptake and increased systemic oxygen uptake in cirrhosis are normalized after liver transplantation. Liver Transpl. 2001;7(12):1015-22.
Tietge, U. J., Bahr, M. J., Manns, M. P., & Böker, K. H. (2001). Decreased splanchnic oxygen uptake and increased systemic oxygen uptake in cirrhosis are normalized after liver transplantation. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 7(12), 1015-22.
Tietge UJ, et al. Decreased Splanchnic Oxygen Uptake and Increased Systemic Oxygen Uptake in Cirrhosis Are Normalized After Liver Transplantation. Liver Transpl. 2001;7(12):1015-22. PubMed PMID: 11753903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decreased splanchnic oxygen uptake and increased systemic oxygen uptake in cirrhosis are normalized after liver transplantation. AU - Tietge,U J, AU - Bahr,M J, AU - Manns,M P, AU - Böker,K H, PY - 2001/12/26/pubmed PY - 2002/2/6/medline PY - 2001/12/26/entrez SP - 1015 EP - 22 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl VL - 7 IS - 12 N2 - The aim of this study is to (1) characterize the impact of orthotopic liver transplantation (OLT) on splanchnic and systemic oxygen uptake (VO(2)) in patients with liver cirrhosis, and (2) investigate possible influencing factors, as well as metabolic consequences, of reduced splanchnic VO(2) in patients with cirrhosis. Therefore, we measured systemic VO(2) (indirect calorimetry), portal pressure (hepatic venous pressure gradient), hepatic blood flow (HBF; primed continuous infusion of indocyanine green), and hepatic turnover (arteriohepatic venous concentration differences multiplied by HBF) of oxygen, glucose, free fatty acids (FFAs), and aromatic amino acids (AAAs) in 52 patients with advanced cirrhosis and 16 patients with a clinically stable long-term course after OLT. Systemic VO(2) was significantly increased in patients with cirrhosis (261 +/- 7 mL/min) and normalized after OLT (216 +/- 8 mL/min; P < .001). Arterial and hepatic venous oxygen saturation and splanchnic oxygen extraction (in percent) were not different between patients with cirrhosis and after OLT. Splanchnic VO(2) was decreased in patients with cirrhosis (41 +/- 3 mL/min, representing 16% +/- 1% of systemic VO(2)) and normalized after OLT (69 +/- 6 mL/min; P < .001, representing 32% +/- 3% of systemic VO(2); P < .001). In patients with cirrhosis, a decrease in HBF was associated with decreased splanchnic VO(2) (r = 0.74; P < .001). Conversely, decreased splanchnic VO(2) reflected a decrease in hepatic glucose production (r = 0.34; P = .01) and hepatic extraction of FFAs (r = 0.40; P < .01) and AAAs (r = 0.30; P < .05). These results show that (1) splanchnic and systemic VO(2) normalize after OLT, indicating correction of hepatic and extrahepatic metabolic derangements; (2) in cirrhosis, HBF becomes limiting for hepatic oxygen supply; and (3) impaired splanchnic VO(2) reflects a decrease in metabolic liver function. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/11753903/Decreased_splanchnic_oxygen_uptake_and_increased_systemic_oxygen_uptake_in_cirrhosis_are_normalized_after_liver_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1527646501891449 DB - PRIME DP - Unbound Medicine ER -