{"id":86871,"date":"2000-10-10T00:00:00","date_gmt":"2000-10-10T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/utilidad-del-shunt-portocava-intraoperatorio-en-el-trasplante-hepatico-clinico\/"},"modified":"2000-10-10T00:00:00","modified_gmt":"2000-10-10T00:00:00","slug":"utilidad-del-shunt-portocava-intraoperatorio-en-el-trasplante-hepatico-clinico","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/utilidad-del-shunt-portocava-intraoperatorio-en-el-trasplante-hepatico-clinico\/","title":{"rendered":"Utilidad del shunt portocava intraoperatorio en el trasplante hepatico clinico"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Laura Llado Garriga <\/strong><\/h2>\n<p>Uno de los aspectos del trasplante hepatico que ha suscitada m\u00e1s controversia es el manejo de la fase anhep\u00e1tica. Para su control hemodinamico se han ideado diversos recursos tecnicos a lo largo de la historia del trasplante, siendo uno de ellos el shunt porto-cava temporal peroperatorio.  objetivo. Establecer si la realizaci\u00f3n de un shunt porto-cava (spc) temporal durante el trasplante hep\u00e1tico con preservaci\u00f3n de vena cava, mejora la evoluci\u00f3n hemodin\u00e1mica durante el mismo asi como la evoluci\u00f3n posterior.  pacientes y metodos: se estudian de forma prospectiva todos aquellos pacientes cirr\u00f3ticos trasplantados en nuestro centro desde noviembre de 1998, randomiz\u00e1ndolos en dos grupos: grupo spc(n=25) y grupo nospc(n=25). En todos los casos se utiliz\u00f3 la tecnica con preservaci\u00f3n de cava.  resultados. No hubieron diferencias significativas en la duraci\u00f3n del th(spc: 383+-65 vs nospc: 383 +-63 min, p=n.S). Se requiri\u00f3 una media de 25+-10 minn para la realizaci\u00f3n del shunt. El 44% de los pacientes del grupo spc no requirieron trasfusi\u00f3n, mientras que s\u00f3lo el 20% del grupo no spc fueron trasplantados sin trasfusion(p=0,06). Al inicio de la fase anhepatica la disminuci\u00f3n del gasto cardiaco fue mayor en el grupo nospc (-7+-23vs-19+-171\/min, p=0,04). Asimismo la presi\u00f3n portal fue mayor (25+-9 vs 35+- y mmgh, p=0,03), as\u00ed como las resistencias venosas perifericas (685+-288 vs 765+- 300 din-seg\/cm5, p=0,05). La diuresis durante la fase anhepatica fue mayor en el grupo spc(1100+-645 vs 772+-486 ml, p=0,04). Los pacientes con mayor flujo portal al inicio del th(&gt;1000 ml\/min) se benefician especialmente de la realizaci\u00f3n del shunt porto-cava, aumentado las diferencias en la disminuci\u00f3n del gasto cardiaco(2,9+-15 vs-15,6+-191\/min,p=0,04). Asimismo los pacientes con gradiente de presi\u00f3n portal-vena cava &gt; 16 mm hg se benefician, mayormente del shunt porto-cava, requiriendo menor transfusion de hematies (2,1+- 2,5 vs 4,4+- 3,<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Utilidad del shunt portocava intraoperatorio en el trasplante hepatico clinico<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Utilidad del shunt portocava intraoperatorio en el trasplante hepatico clinico <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Laura Llado Garriga <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Barcelona<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 10\/10\/2000<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Joan Figueras Felip<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: eduard Jaurrieta mas <\/li>\n<li>Manuel Gomez fleitas (vocal)<\/li>\n<li>Carlos Margarit creixell (vocal)<\/li>\n<li>Francisco Acosta villegas (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Laura Llado Garriga Uno de los aspectos del trasplante hepatico que ha suscitada m\u00e1s controversia es el [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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