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Mechanisms of the ascites volume differences between patients receiving a left or right hemi-liver graft liver transplantation: From biofluidic analysis

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单位: [1]Capital Med Univ, Beijing Friendship Hosp, Dept Gen Surg, Liver Transplantat Sect, Beijing 100050, Peoples R China [2]Univ Sci & Technol Beijing, Beijing 100083, Peoples R China [3]Tsinghua Univ, Beijing 100084, Peoples R China [4]30 Xueyuan Rd, Beijing 100083, Peoples R China
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关键词: Biofluid mechanics Computational fluid dynamics simulation Left or right liver transplantation Hemodynamics

摘要:
<bold>Background and objective</bold>: Post-transplant refractory ascites (RA) is common in patients receiving living donor liver transplantation (LDLT) using a left hemi-liver graft than in those using a right hemi-liver graft. However, there is currently no clear mechanism explaining the effect of grafts on ascites drainage. The purpose of this study is to analyze the values of blood flow parameters in the portal vein under different grafts using computational fluid dynamics (CFD) to interpret the relationship between portal pressure values with ascites drainage.<bold>Methods</bold>: In this work, ascites drainage was counted in 30 patients who underwent left-sided liver transplantation and 26 patients who underwent right-sided liver transplantation. The portal vein flow models of the transplanted liver under different flow rates were established based on computed tomography (CT) images and finite element theory. Ascites drainage and blood flow parameters were qualitatively compared.<bold>Results</bold>: The results show that the ascites drained from patients who received LDLT with a left hemiliver is three times as that with a right hemi-liver. The simulation results show that the coefficient of the pressure-velocity curve of the left-liver is 1.7 times of the right-liver under the same hydrodynamic conditions, which qualitatively agrees with the clinical data. Moreover, the streamline of the transplanted left liver shows more vortexes compared with the right liver, which is a major reason for the left liver's higher pressure value.<bold>Conclusion</bold>: This clinical phenomenon is reproduced and comprehensively explained by the hemodynamic parameters of the portal vein. This work establishes the relationship between portal pressure values and floating water drainage, and offers a new way for physicians to predict postoperative risks intuitively. (c) 2022 Elsevier B.V. All rights reserved.

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出版当年[2021]版:
大类 | 2 区 工程技术
小类 | 2 区 计算机:理论方法 2 区 工程:生物医学 3 区 计算机:跨学科应用 3 区 医学:信息
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 计算机:跨学科应用 2 区 计算机:理论方法 2 区 工程:生物医学 3 区 医学:信息
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出版当年[2020]版:
Q1 COMPUTER SCIENCE, THEORY & METHODS Q1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Q1 ENGINEERING, BIOMEDICAL Q1 MEDICAL INFORMATICS
最新[2023]版:
Q1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Q1 COMPUTER SCIENCE, THEORY & METHODS Q1 ENGINEERING, BIOMEDICAL Q1 MEDICAL INFORMATICS

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2020版] 出版当年五年平均[2016-2020] 出版前一年[2019版] 出版后一年[2021版]

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第一作者单位: [1]Capital Med Univ, Beijing Friendship Hosp, Dept Gen Surg, Liver Transplantat Sect, Beijing 100050, Peoples R China [3]Tsinghua Univ, Beijing 100084, Peoples R China
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通讯机构: [2]Univ Sci & Technol Beijing, Beijing 100083, Peoples R China [4]30 Xueyuan Rd, Beijing 100083, Peoples R China [*1]30 Xueyuan Road, Haidian District, Beijing 100083,China
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