Early detection of graft function using hepatic venous oxygen saturation in pig liver transplantation.
In this study, we measured hepatic venous oxygen saturation (Shvo2) in pig liver transplantations in order to evaluate its usefulness as a predictor of early postoperative graft function. Shov2 of the grafts with good function was over 60% after reperfusion, and the mean Shov2 at end of the operations was 69.8+/-6.9%. Shov2 of the grafts with poor function never increased over 60%, and for most of the operation until its end, Shov2 was under 50%. At the end of the operations, the mean Shov2 was 39.7+/-5.5%. Shov2 levels of the grafts with good function were significantly higher than those of the grafts with poor function (P=0.0016). Corresponding with these Shov2 data, glutamic-oxaloacetic transaminase and lactate dehydrogenase levels of grafts with poor function were significantly higher than those of the grafts with good function. Shov2 represents a summation of the hemoglobin oxygen saturation at the venous end of the sinusoids of the liver and indicates adequate hepatic blood flow if the hepatic oxygen is constant. A decrease of Shov2 in poor graft function might indicate a disturbance of microcirculation in the sinusoids. Through the use of Shov2, we are able to recognize conditions of microcirculatory disturbance more quickly than with any other system. In conclusion, Shov2 is a useful indicator for an early and reliable prediction of outcome in liver transplantation.
Katsuramaki
T
T
Department of Surgery, Sapporo Medical University, School of Medicine, Chuo-ku, Japan.
Matsuno
T
T
Hirata
K
K
Isobe
M
M
Sato
H
H
Tsuruma
T
T
Tarumi
K
K
Yagihashi
A
A
D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006503:Hepatic Veins / Q000737:chemistry*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D016031:Liver Transplantation / Q000502:physiology*; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood / Q000378:metabolism*; D013552:Swine
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D010100:Oxygen