title: [In situ protection of the liver with Bretschneider HTK solution].
abstract: Liver resections are usually performed under occlusion of the hepatoduodenal ligament (Pringle manoeuvre) in order to limit operative blood loss. The maximal ischemic tolerance, although individually different, is generally accepted to be 60 min. Resections of centrally located tumors require precise preparation, sometimes combined with vascular reconstructions. In such cases a prolonged ischemic time is inevitable. A save prolongation of the ischemic tolerance could be useful for extensive liver resections. In an experimental study in pigs ischemic tolerance of the liver was studied under hypothermic protection with the HTK solution of Bretschneider during 2 and 3 h. Deterioration of liver function was compared with a warm ischemia during 2 h. Results showed significantly less serum transaminase activities and better hepatic blood flow (ICG test) after an ischemia under protection with the HTK solution compared to a warm ischemia during 2 h. A prolonged ischemia during 3 h under protection with the HTK solution was well tolerated. First clinical applications of hypothermic hepatic protection during resection were successful.
authors.affiliation: Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule, Hannover, Bundesrepublik Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Lamesch
authors.forename: S
authors.initials: S
authors.lastname: Raygrotzki
authors.forename: G
authors.initials: G
authors.lastname: Kehrer
authors.forename: G
authors.initials: G
authors.lastname: Gubernatis
authors.forename: B
authors.initials: B
authors.lastname: Ringe
authors.forename: B
authors.initials: B
authors.lastname: Evers
authors.forename: E A
authors.initials: EA
authors.lastname: Yacoub
authors.forename: R
authors.initials: R
authors.lastname: Pichlmayr
mesh_terms: D000818:Animals; D005947:Glucose; D006498:Hepatectomy / Q000379:methods*; D007036:Hypothermia, Induced / Q000379:methods*; D008099:Liver / Q000098:blood supply*; D008111:Liver Function Tests / Q000379:methods; D008353:Mannitol; D009926:Organ Preservation / Q000379:methods*; D011189:Potassium Chloride; D011343:Procaine; D015424:Reperfusion / Q000379:methods; D013552:Swine
chemical_list: C039984:Bretschneider cardioplegic solution; D008353:Mannitol; D011343:Procaine; D011189:Potassium Chloride; D005947:Glucose
vernacular_title: In-situ-Protektion der Leber mit der HTK-Lösung nach Bretschneider.