Effect of terlipressin on systemic and hepatic hemodynamics in patients undergoing liver transplantation

Figures & data

Figure 1. FLOW chart of the study.

Table 1. Comparison between Cases (with Terlipressin) and Control (without Terlipressin) according to demographic data, diagnosis and comorbidities.

	Cases (with Terlipressin)	Control (without Terlipressin) “number = 15”	Test value	p-value
Demographic data
Age (years)
Mean±SD	46.27 ± 13.48	51.33 ± 11.84	t:1.094	0.283
Range	28–60	30–60
Sex
Female	5 (33.3%)	6 (40.0%)	x^2:0.14	0.705
Male	10 (66.7%)	9 (60.0%)
Body Mass Index (BMI [Kg/m2)
Mean±SD	27.53 ± 4.66	27.60 ± 4.40	t:0.040	0.968
Range	18–32	20–34
Model for End stage Live Disease (MELD) score:
Mean±SD	13.40 ± 2.31	11.73 ± 3.28	t:1.612	0.118
Range	10–17	9–16
Child score
Mean±SD	10.10 ± 2.40	8.80 ± 2.70	t:1.394	0.174
Range	7–14	5–12
Child-Pugh class
A	0 (0.0%)	3 (20.0%)	x^2:3.692	0.158
B	7 (46.7%)	7 (46.7%)
C	8 (53.3%)	5 (33.3%)
Diagnosis
ESLD	15 (100.0%)	15 (100.0%)	0.000	1.000
HCV	11 (73.3%)	11 (73.3%)	0.000	1.000
PVT	0 (0.0%)	8 (53.3%)	10.909	<0.001**
HBV	2 (13.3%)	2 (13.3%)	0.000	1.000
Cryptogenic	0 (0.0%)	2 (13.3%)	2.143	0.143
HCC	6 (40.0%)	5 (33.3%)	0.144	0.705
Sclerosing cholangitis	2 (13.3%)	0 (0.0%)	2.143	0.143
AIH	2 (13.3%)	0 (0.0%)	2.143	0.143
Comorbidities
DM	10 (66.7%)	7 (46.7%)	1.222	0.269
HTN	5 (33.3%)	2 (13.3%)	1.623	0.203
BA	3 (20.0%)	6 (40.0%)	1.429	0.232
SLE	2 (13.3%)	0 (0.0%)	2.143	0.143

ESLD: end stage liver disease. HCV: hepatitis C virus. PVT: portal vein thrombosis. HBV: hepatitis B virus. HCC: hepatocellular carcinoma. AIH: Autoimmune hepatitis.

DM: diabetes mellitus. HTN:hypertension. BA: bronchial asthma.SLE: Systemic lupus erythematosus.

Using: t-Independent Sample t-test; x2: Chi-square test.

p-value >0.05 is insignificant; *p-value <0.05 is significant; **p-value <0.001 is highly significant.

Table 2. Comparison between Cases (with Terlipressin) and Control (without Terlipressin) according to systolic and diastolic blood pressure (mmHg) and heart rate at different intraoperative stages.

Time	Cases (with Terlipressin) “number = 15”	Control (without Terlipressin) “number = 15”	t-test	p-value
Systolic Blood Pressure (mmHg) SBP
T1
Mean±SD	114.67 ± 26.69	108.00 ± 12.07	0.881	0.386
Range	60–140	90–120
T2
Mean±SD	100.67 ± 22.51	104.00 ± 12.42	−0.502	0.619
Range	60–130	90–120
T3
Mean±SD	110.67 ± 12.80	99.07 ± 13.15	2.448	0.021*
Range	80–130	80–130
T4
Mean±SD	132.67 ± 7.99	107.33 ± 16.68	5.306	<0.001**
Range	120–140	90–140
Diastolic Blood Pressure (mmHg) DPB
T1
Mean±SD	75.33 ± 13.56	72.00 ± 10.14	0.762	0.452
Range	50–90	60–80
T2
Mean±SD	67.33 ± 15.80	61.33 ± 12.46	1.155	0.258
Range	50–90	50–90
T3
Mean±SD	69.33 ± 17.51	66.67 ± 9.76	0.515	0.610
Range	40–90	60–80
T4
Mean±SD	88.00 ± 4.14	66.00 ± 14.04	5.821	<0.001**
Range	80–90	50–90
Heart rate(beat per minute)
T1
Mean±SD	72.00 ± 9.41	77.33 ± 14.86	−1.174	0.250
Range	60–80	60–100
T2
Mean±SD	82.67 ± 4.58	86.87 ± 9.16	1.588	0.123
Range	70–80	70–120
T3	76.67 ± 12.52
Mean±SD	60–120	85.33 ± 10.23	2.075	0.047*
Range		70–120
T4
Mean±SD	81.67 ± 9.89	89.40 ± 8.32	2.316	0.028*
Range	70–110	77–130

Note: T1: after induction (as baseline),T2: after one hour of induction,T3: Anhepatic phase T4:Neohepatic phase.

Using: t-Independent Sample t-test.

p-value >0.05 is insignificant; *p-value <0.05 is significant; **p-value <0.001 is highly significant.

Data are presented as mean ± SD.

Table 3. Comparison between Cases (with Terlipressin) and Control (without Terlipressin) according to norepinephrinedose“microgram/kg/hour”.

Time	Cases (with Terlipressin) “number = 15”	Control (without Terlipressin) “number = 15”	t-test	p-value
T1
Mean±SD	2.00 ± 0.00	2.30 ± 0.60	1.910	0.066
Range	2–2	2–4
T2
Mean±SD	2.00 ± 0.00	2.00 ± 0.00	0.000	1.000
Range	2–2	2–2
T3
Mean±SD	3.03 ± 1.03	3.90 ± 1.12	2.214	0.035*
Range	2–4	1–6
T4
Mean±SD	2.10 ± 1.19	3.75 ± 1.96	2.111	0.044*
Range	1–4	1–6

Note: T1: after induction (as baseline),T2: after one hour of induction,T3: Anhepatic phase T4:Neohepatic phase.

Using: t-Independent Sample t-test.

p-value >0.05 is insignificant.

Table 4. Comparison between Cases (with Terlipressin) and Control (without Terlipressin) according to Base deficit and serum lactate.

Time	Cases (with Terlipressin) “number = 15”	Control (without Terlipressin) “number = 15”	t-test	p-value
Base deficit
T1
Mean±SD	−1.06 ± 4.74	−2.43 ± 3.34	0.917	0.367
Range	−5.2–5.5	−9_2
T2
Mean±SD	−2.29 ± 4.49	−1.17 ± 4.50	−0.686	0.498
Range	−6_5	−10_5
T3
Mean±SD	−7.51 ± 1.56	−1.59 ± 3.98	−5.358	<0.001**
Range	−10_-5	−11_1.4
T4
Mean±SD	−2.89 ± 1.32	−4.27 ± 2.07	2.177	0.038*
Range	−10_-1	−9_-1
Serum lactate
T1
Mean±SD	1.53 ± 0.40	1.96 ± 1.31	−1.204	0.239
Range	1–2	0.8–5
T2
Mean±SD	2.62 ± 1.38	2.51 ± 1.90	0.176	0.862
Range	1–4	0.9–6
T3
Mean±SD	5.86 ± 1.55	3.54 ± 1.04	4.825	<0.001**
Range	4.6–8.7	2–5
T4
Mean±SD	2.37 ± 0.83	3.55 ± 1.53	−2.642	0.013*
Range	1–3.5	1–5.1

T1: after induction (as baseline), T2: after one hour of induction, T3: Anhepatic phase T4: Neohepatic phase.

Using: t-Independent Sample t-test.

p-value >0.05 is insignificant; *p-value <0.05 is significant; **p-value <0.001 is highly significant.

Data are presented as mean ± SD.

Table 5. Comparison between Cases (with Terlipressin) and Control (without Terlipressin) according to blood loss and blood product given.

	Cases (with Terlipressin) “number = 15”	Control (without Terlipressin) “number = 15”	Test value	p-value
Blood loss (ml)
Mean±SD	2026.67 ± 904.33	1584.00 ± 600.06	U:1.580	0.125
Range	1000–3000	780–2700
PRBC(packed RBC)(ml)
Mean±SD	1933.33 ± 1032.80	1584.00 ± 600.06	U:0.677	0.504
Range	1000–3000	780–2700
Plasma given
No	11 (73.3%)	9 (60.0%)	x^2:0.600	0.439
Yes	4 (26.7%)	6 (40.0%)
Plasma given (ml)
Mean±SD	1050.00 ± 866.03	900.00 ± 328.63	U:0.393	0.704
Range	300–1800	600–1200

Using: U=Mann–Whitney test; x2: Chi-square test.

p-value >0.05 is insignificant.

Table 6. Comparison between Cases (with Terlipressin) and Control (without Terlipressin) according to hepatic hemodynamic.

Hepatic Hemodynamics	Cases (with Terlipressin) “n = 15”	Control (without Terlipressin) “n = 15”	Test value	p-value
Hepatic artery resistive index
Mean±SD	0.65 ± 0.10	0.61 ± 0.04	t:1.257	0.219
Range	0.53–0.76	0.6–0.71
Portal vein flow velocity (cm/sec)
Mean±SD	59.87 ± 10.35	79.07 ± 15.15	t:4.052	<0.001**
Range	50–78	60–100
Portal venous pressure (mmHg)
Mean±SD	7.13 ± 1.63	8.93 ± 2.58	t:2.284	0.030*
Range	6–10	4–11
Hepatic vein flow
Triphasic	15 (100.0%)	15 (100.0%)	x^2:0.00	1.000

Using: t-Independent Sample t-test; x2: Chi-square test.

p-value >0.05 is insignificant; *p-value <0.05 is significant; **p-value <0.001 is highly significant.