Biotechnologies and acute hepatic failure.
Orthotopic liver transplantation survival for patients with acute liver failure is poor (50%). Mortality on the waiting list is high due to the lack of donors. For these reasons, the possibility of sustaining hepatic function by extra-corporeal liver perfusion must be considered. In this experimental research, two groups of pigs have been submitted to total de-vascularisation of the liver causing acute hepatic failure. In the first group (4 pigs) no extra-corporeal assistance has been used after total de-vascularisation. All pigs died between 16 and 33 hours after the acute hepatic failure was induced. In the second group (8 pigs) after complete hepatic de-vascularisation an extra-corporeal hepatic support by continuous allo-perfusion of isolated liver was performed using the Abouna-Costa extra-corporeal circuit. All pigs were observed during the acute hepatic failure which lasted from 6.30 to 7.30 hours. The data that were more positively influenced by the extra-corporeal assistance were ammonia and lactates that improved after the application of hepatic assistance.
Fassati
L R
LR
Istituto di Chirurgia Sperimentale e dei Trapianti, Università di Milano, Unità Operativa per il Trapianto e la Chirurgia del Fegato e del Polmone, Ospedale Maggiore IRCCS, Milano.
Gatti
S
S
Caccamo
L
L
Latham
L
L
Rossi
G
G
Prato
P
P
Giammarinaro
G
G
D000818:Animals; D005112:Extracorporeal Circulation; D008099:Liver / Q000098:blood supply*; D017114:Liver Failure, Acute / Q000628:therapy*; D013552:Swine