Portal and arterial washout after hypothermic preservation of the pig liver: prevention of hyperkalaemia after revascularization.
In an orthotopic liver transplantation (OLT), portal revascularization may produce acidosis and hyperkalaemia due to loss of intracellular acid metabolites and K+ during hypothermic preservation. To verify the effectiveness of portal and arterial washout in preventing hypokalaemia after liver preservation, an OLT was done in 18 large-white pigs. The donor livers were perfused in situ via the portal vein with Hartmann's solution containing 1.000 IU of heparin at 4 degrees C. Afterwards, a cold Collins C2 solution was perfused either in vitro (group A) or in situ (group B). The cold ischemia time in both groups was less than 3 1/2 h. Before doing the portal revascularization of the donor livers, a washout via the portal vein and hepatic artery with saline serum was performed. The concentration of K+, glucose, GOT and LDH in effluents obtained through infrahepatic inferior vena cava were significantly lower in group B than in group A. Simple washout of the livers prior to revascularization prevented hyperkalaemia in both groups.
Arias
J
J
I Catedra Patología Quirúrgica Hospital Clínico de San Carlos Universidad Complutense de Madrid, Spain.
Aller
M A
MA
Fernandez-Cordero
X
X
Estebanez
E
E
Jimenez
G
G
Enterría
F G
FG
Brandau
D
D
Duran
H
H
D000818:Animals; D006499:Hepatic Artery; D006947:Hyperkalemia / Q000517:prevention & control*; D007036:Hypothermia, Induced / Q000379:methods*; D008099:Liver / Q000098:blood supply; D008102:Liver Circulation; D016031:Liver Transplantation; D009926:Organ Preservation / Q000379:methods*; D010477:Perfusion / Q000379:methods; D011169:Portal Vein; D011188:Potassium / Q000097:blood; D013552:Swine
D011188:Potassium