Monitoring leakage during isolated hepatic perfusion.
The toxicity of the drug used during isolated hepatic perfusion, such as tumor necrosis factor alpha, necessitates the assessment of leakage. The liver is an organ that, apart from the vessels and the bile duct, can be separated completely from the surrounding body tissue. Leakage can still occur, however, with possible sites at the veins connecting to the caval vein. The caval vein should be freed as much as possible. Drug levels in the perfusate and venous blood can be determined only retrospectively; and because they can be interpreted in different ways they are not sufficient for measuring leakage. If radiolabeled albumin is injected into the perfusion circuit and detector is placed over the centrifugal perfusion pump (used for the venovenous bypass over the blood reservoir) the accumulation in the systemic blood can be measured. Of al the methods used today this technique seems to be the most sensitive.
Department of Surgery, Sahlgrenska University Hospital, Göteborg University, Sweden.
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Lindnér
D000818:Animals; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects*; D016903:Drug Monitoring / Q000379:methods*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D006801:Humans; D008099:Liver / Q000187:drug effects*; D012680:Sensitivity and Specificity; D013667:Technetium
D013667:Technetium