title: The effect of hypothermic perfusion with oxygenated perfluorochemical during in situ extended hepatectomy of canine liver.
abstract: BACKGROUND
  An oxygen supply is necessary to maintain the energy metabolism of hepatic cells even at low temperatures in total hepatic vascular exclusion (THVE). Little has been written regarding the effect of an oxygenated perfusate for hypothermic perfusion in THVE, required for extended hepatectomy.
  
  
  METHODS
  Adult mongrel dogs (n=15) were used. Total hepatic vascular exclusion with active venovenous bypass was maintained for 60 minutes and 75 percent of the liver was resected. The LR group (n=7) was perfused using a 4 degrees C Ringer's lactate solution, and the FC43 group (n=8) with 4 degrees C oxygenated perfluorochemical. Blood samples from the hepatic vein were collected in order to measure alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), purine nucleoside phosphorylase (PNP), and NH(3).
  
  
  RESULTS
  At every sampling point after hepatectomy, the serum AST levels of hepatic venous blood were significantly lower (p<0.05) in the FC43 group than in the LR group. Serum ALT, LDH, and PNP levels were significantly lower (p<0.05) in the FC43 group than in the LR group immediately after reperfusion. Plasma NH(3) levels were significantly lower (p<0.05) in the FC43 group than in the LR group, 30 minutes and two hours after reperfusion.
  
  
  CONCLUSIONS
  Hypothermic perfusion using oxygenated perfluorochemical prevents hepatic cell damage during in situ extended hepatectomy.
authors.affiliation: Second Department of Surgery, Gunma University School of Medicine, Gunma Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ohya
authors.forename: S
authors.initials: S
authors.lastname: Ohwada
authors.forename: Y
authors.initials: Y
authors.lastname: Kawashima
mesh_terms: D000818:Animals; D004285:Dogs; D004655:Emulsions; D005466:Fluorocarbons / Q000008:administration & dosage*; D006498:Hepatectomy / Q000379:methods*; D007036:Hypothermia, Induced / Q000379:methods*; D007430:Intraoperative Care / Q000379:methods*; D007552:Isotonic Solutions / Q000008:administration & dosage; D008099:Liver / Q000201:enzymology; D010100:Oxygen / Q000008:administration & dosage*; D010477:Perfusion; D000077325:Ringer's Lactate; D013997:Time Factors
chemical_list: D004655:Emulsions; D005466:Fluorocarbons; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D010100:Oxygen