Abstract
BackgroundTo investigate the effects of retrograde reperfusion on the intraoperative internal environment and hemodynamics in classic orthotopic liver transplantation (OLT).MethodsThirty patients were undergone classic OLT using retrograde reperfusion in our center. Blood sampling was done at different time points including: Before blood venting via the portal vein (PV), 10 mL of blood was collected from the inferior vena cava (T0); During retrograde reperfusion through the inferior vena cava (IVC), 10 mL of blood was collected when the volume of blood venting reached 10 mL (T1), 100 mL (T2), and 200 mL (T3), respectively. 5 mL of blood was analyzed using a NOVA-f–type Blood Gas Analyzer. The remaining 5 mL was measured to determine the level of IL-1β using an enzyme-linked immunosobent assay.ResultsAll operations were completed successfully, and postreperfusion syndrome (PRS) occurred in 6 patients (20%). The most notable findings were significant changes at T1, T2 and T3, including pH value, PvO2, SvO2, BEecf, HCO3−, Lac, K+, Ca2+ and IL-1β, compared with T0 (P < 0.05). Yet their levels at T3 were not back to the level at T0 (P < 0.05).ConclusionThis retrograde perfusion could eliminate some harmful metabolites inside the donor liver in time and reduce acid-base and electrolyte disorders as well as drastic hemodynamic fluctuations after recirculation during classic OLT.
Highlights
To investigate the effects of retrograde reperfusion on the intraoperative internal environment and hemodynamics in classic orthotopic liver transplantation (OLT)
The changes were analyzed in blood gas results and the fluctuations in the arterial pressure during reperfusion of the donor liver using a new type of retrograde reperfusion
The donors were generally younger than 50 years with body mass index (BMI) lower than 30 kg/m2, and serum aminotransferase levels at procurement were less than twice of the normal values
Summary
To investigate the effects of retrograde reperfusion on the intraoperative internal environment and hemodynamics in classic orthotopic liver transplantation (OLT). Many previous studies have reported that retrograde reperfusion through inferior vena cava (IVC) could reduce hemodynamic fluctuations, and the reperfusion method had been improved and used in many centers [10,11,12]. To date, it was still unknown from available literature whether this technique led to the better outcome following transplantation [13, 14]. This study was designed to investigate the effect of retrograde reperfusion on the patient’s intraoperative internal environment and hemodynamics during classic OLT
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