Hemodynamic and metabolic variables predict porcine ex vivo liver function.
Early recognition of hepatic function during initial graft reperfusion is important in beginning hepatic support perfusions as well as in liver transplantation. We hypothesized that both hemodynamic and metabolic perfusion variables obtained immediately after reperfusion predict eventual function during liver support or transplantation. Specific hemodynamic variables, i.e., portal vein pressure and hepatic vascular resistance, as well as metabolic variables, i.e., O(2) consumption and P(CO(2)) gradients, were compared with indices of hepatic function and damage, i.e., aqueous bile production, bile lipid outputs, lactate dehydrogenase levels, and histopathology, during an ex vivo support perfusion. O(2) consumption during early reperfusion correlated directly with unstimulated bile flows (P < 0.02) and histopathology scores (P < 0.05). Hepatic venous P(CO(2)) gradients correlated inversely with unstimulated bile flows (P < 0.05). Hemodynamic variables, i.e., portal vein pressure and hepatic vascular resistance, were inversely related with taurocholate-stimulated bile flows (P < 0.05). Hemodynamic and metabolic variables of early reperfusion are useful parameters in predicting eventual effectiveness of the harvested liver for ex vivo hepatic support perfusions.
Ricciardi
R
R
Department of Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA. rocco.ricciardi@umassmed.edu
Foley
D P
DP
Quarfordt
S H
SH
Vittimberga
F J
FJ
Kim
R D
RD
Donohue
S E
SE
Wheeler
S M
SM
Anwaruddin
S
S
Callery
M P
MP
Meyers
W C
WC
D000818:Animals; D001646:Bile / Q000502:physiology; D002756:Cholagogues and Choleretics / Q000494:pharmacology; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology*; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008099:Liver / Q000098:blood supply / Q000378:metabolism*; D008102:Liver Circulation / Q000502:physiology*; D016031:Liver Transplantation; D010101:Oxygen Consumption; D011169:Portal Vein / Q000502:physiology; D011237:Predictive Value of Tests; D013552:Swine; D013656:Taurocholic Acid / Q000494:pharmacology; D014655:Vascular Resistance / Q000502:physiology
D002756:Cholagogues and Choleretics; D013656:Taurocholic Acid; D007770:L-Lactate Dehydrogenase