Endoluminal laser-Doppler measurements of jejunal perfusion in patients undergoing liver transplantation

Patients undergoing liver transplantation are at risk of developing the multiple organ dysfunction syndrome, and attention has been focused on the pathogenic role of decreased gastro-intestinal mucosal perfusion. The aim of this study was to investigate the use of laser-Doppler flowmetry for determination of jejunal perfusion. In 10 patients an endoluminal laser-Doppler catheter was positioned with the tip in the jejunum for continuous measurements of jejunal perfusion. The anhepatic phase was associated with a progressive decrease in jejunal perfusion to 49 (40/65)% (P < 0.01) of dissection phase value. At the end of surgery the jejunal perfusion had increased to 134 (103/158)% (P < 0.01) of dissection phase jejunal perfusion. The endoluminal laser-Doppler technique was found to be easily applicable for continuous monitoring of jejunal perfusion, and the technique could prove valuable in detecting gastro-intestinal hypoperfusion in patients undergoing liver transplantation.