[Systemic hemodynamics and oxygen transport and consumption during the anhepatic phase of orthotopic liver transplantation in dogs].
During the anhepatic phase of orthotopic liver transplantation, the veno-venous bypass has been used to keep systemic hemodynamics (SHD) in a stable condition. In this study, changes of SHD and oxygen transport and consumption (OTC) during the anhepatic phase used the passive bypass (PB) with Anthron bypass tubes were compared with those used the pump-driven bypass (PDB) with a centrifugal pump in mongrel dogs. Moreover the effects of the increased instillation rate and administration of dobutamine on SHD and OTC were evaluated. The portal venous and inferior vena caval pressure were increased in PB group, but not in PDB group. Whenever PB or PDB was used, cardiac index and oxygen consumption were markedly decreased caused by hypovolemia. In PDB group trebled the instillation rate, SHD and oxygen consumption were not improved. These results suggested that the primarily cardiovascular depression during the anhepatic phase was related to the disturbance of SHD. When dobutamine was administered and the instillation rate was trebled in PDB group, SHD and OTC were maintained in a favorable state. It is concluded that PDB, administration of dobutamine and sufficient instillation are advantageous to maintain systemic hemodynamic stability during the anhepatic phase of orthotopic liver transplantation.
Kato
T
T
Department of Surgery II, Nagoya University School of Medicine, Japan.
Kano
T
T
Nonami
T
T
Takagi
H
H
D000818:Animals; D001243:Assisted Circulation; D002496:Central Venous Pressure / Q000187:drug effects; D004285:Dogs; D004298:Dopamine / Q000494:pharmacology; D006439:Hemodynamics / Q000187:drug effects; D016031:Liver Transplantation / Q000502:physiology*; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000187:drug effects; D011167:Portacaval Shunt, Surgical / Q000379:methods
D010100:Oxygen; D004298:Dopamine