The effect of portal vein bloodletting before reperfusion on homeostasis and cardlopuimonary function during orthotopic liver transplantation / 中华普通外科杂志

ABSTRACT

Objective To investigate the clinical implications of portal vein bloodletting immediately before reperfusion during orthotopic liver transplantation(OLT).Methods Thirty-two patients with end-stage liver diseases undergoing non veno-venous OLT were divided into bloodletting group (n=21)and control group(n=11).During anhepatic phase,we maintained mean arterial pressure ＞70 mm Hg,cardiac index＞2.5 L·min-1·m-2 by infusion,norepinephrine and dopamine.Blood samples were taken at the time when portal vein was clamped(T1),the time when portal vein was unclamped (T2),10 minutes after neohepatic phase(T3),neohepatic phase 30 minutes(T4)for electrolytes,blood gas and plasma inflammatory cytokines.Hemodynamic and ventilation parameters were also recorded.Results There was no significant difference in mortality(X2=1.12,P＞0.05)and arrhythmia incidence (X2=1.73,P＞0.05)between the two groups.Serum calcium,magnesium were both significantly lower than normal.After anhepatic phase,potassium,tumor necrosis factor alpha,interleukin-6 in radial artery didn't alter significantly;Bloodletting had no effect on lactic acid.There was no significant difference in hemodynamic and ventilation parameters among four time periods.Conclusion Bloodletting seemed to have no effect on changes of internal environment.