The influence of different sequences of revascularization on ultrastructural changes in the graft liver and the recovery of short-term liver function after liver transplantation with retrograde reperfusion / 中华肝胆外科杂志

Objective To study the influence of sequential and contemporaneous revascularizations of portal vein and hepatic artery during liver transplantation with retrograde reperfusion on the ultra-structural changes in intrahepatic cholangiocytes of the graft with liver ischernia reperfusion injury,and the recovery of short-term liver function after operation.Methods The clinical data of 97 patients who underwent orthotopic liver transplantation (OLT) using retrograde reperfusion via the vena cava (IVC) in our hospital from January,2009 to June,2013 were retrospectively analyzed.Using to the different sequences of revascularization,97 digible patients were divided into three groups:group R-IPR:the initial arterial revascularization group (35 patients);group R-IAR:the initial portal revascularization group (30 patients);group R-SAPR:simultaneous reperfusion group (32 patients).Liver function,coagulation function and other related parameters were continuously monitored for the transplant recipients at the following time points:1 day before operation,2 hours after reperfusion and on postoperative Day 1,2,5 and 7.The ultra-structure of intrahepatic bile duct epithelial cells at 2 hours after reperfusion were studied by transmission electron microscopy and morphometric analysis of mitochondria was performed by the computer image analysis system.Results The levels of ALT,GGT and TB in group R-IAR were significantly lower than those in group R-IPR and group R-SAPR (P＜0.05).There were no significant differences among the three groups in other parameters that reflected liver function at any time point (P＞0.05).In group R-IAR and group R-IPR,mitochondrial swelling of bile duct epithelial cells was more severe than that in group R-SAPR.There were significant differences among the three groups in the mitochondrial average area and the average perimeter (P＜0.05).Mild swelling of mitochondria in hepatic cells was observed in group R-IAR and group R-IPR.There was no significant difference in the mitochondrial average area and average perimeter between the two groups (P＞0.05).Mitochondrial swelling of hepatic cells was most severe in group R-SAPR.There were significant differences in the average area and average perimeter of hepatic cell mitochondria between group R-SAPR and the other two groups (P＜0.05).Conclusion During liver transplantation with retrograde reperfusion,initial arterial revascularization reduced the short-term levels of transaminases,improved early liver function after operation and protected the intrahepatic bile duct against the second ischemia reperfusion injury.

Técnica de reperfusão miocárdica retrógrada: resgate histórico: [revisión] / Retrograde coronary perfusion technique: hostorical rescue: [review]

Artigo de revisão, numa perpectiva histórica, de trabalho experimental realizado em cães, em 1962, sobre técnica de reperfusão miocárdica retrógrada pelo seio coronariano. Esta técnica pioneira, apresentada neste artigo como um resgate histórico, representa um legado importante pela atual repercussão internacional da sua utilização no tratamento da doença coronariana com células-tronco.

Paper presenting a historical review of an experimental study conducted with dogs in 1962, exploring a retrograde myocardial retroperfusion technique for the coronary sinus. This pioneering approach is presented in this paper in order to preserve this historic feat,constituting an important legacy due to current international repercussions prompted by its use for treating acute myocardial infarction and stem celltreatment of coronary disease.

Intracardiac Repair of the Coronary Sinus Laceration during Retrograde Cardioplegia: A case report / 대한흉부외과학회지

Coronary sinus injuries related to the use of retrograde cardioplegia are rare and have potentially lethal complications. This report describes a case of coronary sinus laceration during retrograde cardioplegia in an old patient with mitral valve regurgitation, endocarditis, and left ventricular hypertrophy, and tells the details of the method of intracardiac repair.