Effect of retrograde perfusion on hemodynamics in orthotopic liver transplantation / 中国组织工程研究

ABSTRACT

BACKGROUND: Ischemic reperfusion syndrome occurs in early donor liver reperfusion after orthotopic liver transplantation. It is the most important cause for liver function failure and patient death. Ischemic reperfusion severity is closely related to blocking of inferior vena cava period. Some studies demonstrate that inferior vena retrograde perfusion can shorten the blocking time during liver transplantation. OBJECTIVE: To observe the effect of retrograde perfusion on the hemodynamics in orthotopic liver transplantation without venovenous bypass during neohepatic reperfusion phase. DESIGN, TIME AND SETTING: Case comparison was performed at Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from December 2006 to June 2007. PARTICIPANTS: Thirty-nine patients underwent orthotopic liver transplantation without venovenous bypass under general anesthesia. METHODS: According to perfusion methods, the patients were divided into two groups retrograde perfusion through inferior vena cave (n=19), and perfusion through portal vein (n=20). MAIN OUTCOME MEASURES: The systolic blood pressure, diastolic blood pressure, heart rate, central venous pressure and other hemodynamic parameters were measured before operation, and at anhepatic phase and primary neohepatic phase. The rewarming ischemia time of grafted liver was also recorded. RESULTS: The rewarming ischemia time of grafted liver in the retrograde perfusion through inferior vena cave group was significantly less than that in the perfusion through portal vein group (P