Hemodynamic changes in clinical orthotopic liver transplantation.

Cardiac output (with cardiogreen dye dilution), heart rate, stroke volume, mean arterial pressure, and central venous pressure (SVC) were measured': I) following induction of anesthesia while the abdomen was being opened, 2) during mobilization of the recipient'S liver, 3) shortly following cross-clamping the inferior vena cava and portal vein (early anhepatic phase), 4) just prior to revascularization of the donor liver (late anhepatic phase), 5) one hr later, and, 6) several hours following transplantation with the recipient awake. Each patient suffered from cirrhosis, portal hypertension, and extensive venous collaterals. There were two children (ages 3Y2 and 3Y2 years) with biliary atresia; 3 adolescents (ages II, lSY2 and 16 years) with chronic aggressive hepatitis, \Vilson's disease and chronic aggressive hepatitis, respectively; and 2 adults (ages 47 and 47 years) with Laennec's cirrhosis. RESULTS Intermittent decreases in cardiac index, stroke volume, and arterial blood pressure were observed before the anhepatic phase apparently because of displac'ement of the native liver and partial