{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:19:39Z","timestamp":1765484379883,"version":"3.40.5"},"reference-count":25,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2023-0191_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Hepatic arterial buffer response (HABR) is an important defence mechanism for maintaining liver blood flow. It is suspected that HABR is active in monochorionic diamniotic twins (MCDA) with twin-to-twin transfusion syndrome (TTTS) where donor compensates a setting of volume depletion and the recipient an overload. The present study investigates whether in TTTS, HABR is active in donor and\/or recipient individually and try to determine if the activation of HABR is a direct response to TTTS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2023-0191_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Hepatic artery (HA) peak systolic velocity (PSV) was measured in normal MCDA fetuses and TTTS. Correlation with relevant fetal Dopplers and characteristics were determined. Z-scores for HA-PSV (HAV-Z) were calculated and its association with TTTS in donors and recipients were determined as well as changes in HAV-Z after laser treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2023-0191_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In this study 118 MCDA were included, 61.9\u202f% normal and 38.1\u202f% TTTS. Of the TTTS 22 required laser treatment. A total of 382 scans were performed in normal group and 155 in TTTS. Our data demonstrates that in donors HAV-Z was 2.4 Z-scores higher compared to normal fetuses (\u03b2=2.429 95\u202f% CI 1.887, 2.971; p&lt;0.001) and after laser treatment HAV-Z reduced (\u03b2=\u22121.829 95\u202f% CI\u00a0\u22122.593,\u00a0\u22121.064; p&lt;0.001). There was no significant difference between recipients and normal (\u03b2=\u22120.092 95\u202f% CI\u00a0\u22120.633, 0.449; p=0.738).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2023-0191_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>HABR is active in TTTS, promoting an increased hepatic blood flow in donors. The activation is direct response to TTTS as shown by the reduction in HAV-Z after laser. This finding provides important insights into the pathophysiology of TTTS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2023-0191","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T19:04:17Z","timestamp":1697569457000},"page":"71-75","source":"Crossref","is-referenced-by-count":2,"title":["Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis"],"prefix":"10.1515","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6002-9022","authenticated-orcid":false,"given":"Jader","family":"de Jesus Cruz","sequence":"first","affiliation":[{"name":"Department of Fetal Medicine , Central Lisbon University Hospitals , Lisbon , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0586-3369","authenticated-orcid":false,"given":"Joana","family":"Bernardeco","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine , Central Lisbon University Hospitals , Lisbon , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Rijo","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine , Central Lisbon University Hospitals , Lisbon , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Fetal Medicine , Central Lisbon University Hospitals , Lisbon , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6332-2902","authenticated-orcid":false,"given":"Fatima","family":"Serrano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics , Central Lisbon University Hospitals , Lisbon , Portugal"},{"name":"Comprehensive Health Research Centre , Universidade Nova de Lisboa , Lisbon , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"2024011107231746999_j_jpm-2023-0191_ref_001","doi-asserted-by":"crossref","unstructured":"Lautt, WW. Mechanism and role of intrinsic regulation of hepatic arterial blood flow: hepatic arterial buffer response. Am J Physiol Gastrointest Liver Physiol 1985;249:G549\u201356. https:\/\/doi.org\/10.1152\/ajpgi.1985.249.5.g549.","DOI":"10.1152\/ajpgi.1985.249.5.G549"},{"key":"2024011107231746999_j_jpm-2023-0191_ref_002","doi-asserted-by":"crossref","unstructured":"Lautt, WW. Regulatory processes interacting to maintain hepatic blood flow constancy: vascular compliance, hepatic arterial buffer response, hepatorenal reflex, liver regeneration, escape from vasoconstriction. Hepatol Res 2007;37:891\u2013903. https:\/\/doi.org\/10.1111\/j.1872-034x.2007.00148.x.","DOI":"10.1111\/j.1872-034X.2007.00148.x"},{"key":"2024011107231746999_j_jpm-2023-0191_ref_003","doi-asserted-by":"crossref","unstructured":"Cruz, JJ, Bernardeco, J, Cohen, A, Serrano, F. Hepatic arterial buffer response in monochorionic diamniotic pregnancies with twin-to-twin transfusion syndrome. 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