European Journal of Anaesthesiology

Table of Contents - 2006 - Volume 23, Issue 05  


Original Article

Spontaneous baroreflex cardiac sensitivity in end-stage liver disease: effect of liver transplantation

F. Lhuillier a1, E. D. Dalmas a1, P. M. Gratadour a1, A. A. Cividjian a2, O. C. Boillot a3, L. Quintin a2 and J. P. Viale a1c1
a1 Hôpital de la Croix-Rousse, Department of Anaesthesia and Intensive Care, Lyon, France
a2 School of Medicine, Department of Physiology, Lyon, France
a3 Hôpital E Herriot, Liver Transplantation Unit, Lyon, France

Article author query
lhuillier f   [PubMed][Google Scholar] 
dalmas ed   [PubMed][Google Scholar] 
gratadour pm   [PubMed][Google Scholar] 
cividjian aa   [PubMed][Google Scholar] 
boillot oc   [PubMed][Google Scholar] 
quintin l   [PubMed][Google Scholar] 
viale jp   [PubMed][Google Scholar] 

Summary

Background and objective: End-stage liver disease is associated with an imbalance in the autonomic nervous system. The purpose of this study was to estimate the effect of liver transplantation on this imbalance. Method: The study involved 10 patients undergoing liver transplantation and 9 patients without liver impairment undergoing liver surgery. The spontaneous baroreflex sensitivity was measured before and 1 month after surgery for the liver surgery group; before and 1, 3, 6, 12 and 18 months after orthotopic liver transplantation. Results: The spontaneous baroreflex slope of patients with end-stage liver disease was decreased before liver transplantation compared to the liver surgery group (3.9 ± 2.5 ms mmHg−1 vs. 9.9 ± 5.0 ms mmHg−1, P = 0.002). The mean slope was significantly increased at 12 and 18 months compared to the pre-transplantation value (3.9 ± 2.5 ms mmHg−1 vs. 8.1 ± 6.6 ms mmHg−1 and 7.4 ± 4.8 ms mmHg−1, respectively; P = 0.042). Nevertheless, further analysis of individual data showed that only four patients exhibited a marked increase in their baroreflex slope 12 months after the liver transplantation whereas it remained decreased in the six others. Conclusions: These results confirm that the baroreflex sensitivity is depressed in end-stage liver disease in line with an autonomic nervous system imbalance. The liver transplantation reverses this disturbance only in some patients.

(Accepted January 13 2006)
(First published online March 1 2006)


Key Words: LIVER TRANSPLANTATION; DYSRHYTHMIA SINUS; AUTONOMIC NERVOUS SYSTEM; BAROREFLEX; LIVER DISEASES, chronic.

Correspondence:
c1 Correspondence to: J. P. Viale, Department of Anaesthesia and Intensive Care, Hôpital de la Croix-Rousse, Lyon, France. E-mail: jean-paul.viale@chu-lyon.fr; Tel: +33 472 07 24 26; Fax +33 472 07 19 85

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