Key result
Liver transplantation significantly increased the mean spontaneous baroreflex slope at 12 months compared to pre-transplantation values (8.1 vs 3.9 ms/mmHg, P=0.042), though recovery was variable.
Why the study?
Does liver transplantation improve spontaneous baroreflex sensitivity in patients with end-stage liver disease?
Observational (n=19)
Does liver transplantation improve spontaneous baroreflex sensitivity in patients with end-stage liver disease?
Liver transplantation reverses depressed baroreflex sensitivity in some, but not all, patients with end-stage liver disease.
Answers are grounded in this paper and cite their sources.
May restore baroreflex sensitivity in some patients after liver transplantation; hypothesis-generating and requires prospective validation before clinical adoption.
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.
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Lhuillier et al. (2006) conducted an observational in End-stage liver disease (n=19). Liver transplantation vs. Pre-transplantation baseline was evaluated on Spontaneous baroreflex sensitivity slope at 12 months (p=0.042). Liver transplantation significantly increased the mean spontaneous baroreflex slope at 12 months compared to pre-transplantation values (8.1 vs 3.9 ms/mmHg, P=0.042), though recovery was variable.
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