Venovenous bypass ahead of mobilization of the liver in orthotopic liver transplantation.
BACKGROUND
To evaluate feasibility and safety of venovenous bypass prior to mobilization of the liver during orthotopic liver transplantation (OLT).


METHODS
Fifty-four patients were classified into two groups. Group A consisted of 23 patients receiving OLT with classical venovenous bypass. Group B consisted of 31 patients who received a modified-procedure: venovenous bypass ahead of the mobilization of the liver during OLT. The blood loss, duration of venovenous bypass, cold ischemia time, anhepatic phase, and transfusion during operation in the two groups were compared. Complications after the operation were also compared between the two groups.


RESULTS
The duration of venovenous bypass and cold ischemia time in group A were longer than those in group B [(99.78+/-21.36 min) vs (96.32+/-22.25 min) and (484.78+/-134.01 min) vs (443.15+/- 85.27 min)]. The anhepatic phase lasted for about 100 min averagely in the two groups. The volumes of blood loss and transfusion during the operation were larger in group A than in group B [(5096+/-4243 ml) vs (1726+/-1125 ml) and (3676+/-2938.74 ml) vs (1217.69+/-829.72 ml)]. Postoperative complications occurred in 26 patients of group A and in 19 patients of group B.


CONCLUSIONS
This modified-procedure or venovenous bypass ahead of mobilization of the liver in OLT can reduce the blood loss during OLT and the incidence of postoperative complications without prolongation of the anhepatic phase and duration of venovenous bypass.
Yan
Lu-Nan
LN
Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, China. yanluan@hotmail.com
Wang
Wei
W
Li
Bo
B
Lu
Shi-Chun
SC
Wen
Tian-Fu
TF
Zeng
Yong
Y
Cheng
Nan-Sheng
NS
Zhao
Ji-Chun
JC
Lin
Qi-Yuan
QY
Chen
Xiao-Li
XL
Wu
Xiao-Ding
XD
Jia
Qian-Bin
QB
Zhou
Yong
Y
Tu
Bin
B
Wu
Yan-Tao
YT
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002648:Child; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D014656:Vascular Surgical Procedures / Q000379:methods*