The experimental study on the temporary portal vein arterialization in the canine liver transplantation: preliminary report.
To evaluate the feasibility of temporary portal vein arterialization (PVA) in orthotopic partial liver transplantation (PLT), we performed 5 canine PLTs with PVA assessing the changes in arterial ketone body ratio (AKBR) as an index of hepatic energy status, and measuring portal pressure and flow. After anastomosis of hepatic vein, the graft liver was revascularized with arterial blood shunted from the external iliac artery to the hepatic side of the portal vein. By using this technique, both anhepatic period of the recipient and ischemic time, especially warm ischemic time, of the allograft were markedly shortened (31.0 +/- 4.5 min: Mean +/- SEM). Four out of 5 recipients survived for at least 5 days (13 days in average). The AKBR was restored immediately after PVA and showed almost the same values as those at preclamping and after completion of anastomoses of both portal vein and hepatic artery. No significant difference in portal venous pressure was observed between during PVA and after vascular reconstruction. Portal blood flow during PVA was about one fourth of the total hepatic blood flow at preclamping. These results suggest that PVA can be used as an alternative procedure in PLT.
Kobayashi
N
N
Second Department of Surgery, Faculty of Medicine, Kyoto University, Japan.
Konishi
Y
Y
Higashiyama
H
H
Kumada
K
K
Yamaoka
Y
Y
Tanaka
K
K
Shimahara
Y
Y
Mori
K
K
Okamoto
R
R
Egawa
H
H
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001794:Blood Pressure; D004285:Dogs; D007083:Iliac Artery / Q000601:surgery; D007657:Ketone Bodies / Q000097:blood; D008102:Liver Circulation; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D011169:Portal Vein / Q000502:physiology / Q000601:surgery*
D007657:Ketone Bodies