[A newly-established method of isolated hypoxic hepatic perfusion].
OBJECTIVE
To establish a simplified isolated hypoxic hepatic perfusion (IHHP) technique, and to provide basis for IHHP using balloon occlusion catheter technique.


METHODS
Twelve rabbits were randomly divided into two groups: IHHP group and transcatheter arterial infusion (TAI) group. Technique of IHHP: the aorta above celiac axis was clamped, the retrohepatic inferior vena cava (IVC) was clamped above and below the level of the hepatic veins and an outflow catheter was introduced into this isolated segment via a femoral vein. The inflow catheter was introduced into the gastroduodenal artery, and common hepatic artery was clamped. The perfusate which contained Mitomycin C (MMC, 0.5 mg/kg) were perfused into hepatic artery, the hepatic outflow was draw out, and then perfused through hepatic artery again, the perfusion continued for 15 minutes. At the end of the IHHP procedure a washout was performed with 50 mL hespander for 5 minutes. TAI group method: Transarterial infusion was performed via hepatic artery using the same dose of MMC. Blood (2 mL) was sampled from hepatic vein and peripheral vein at multiple time points from the start of perfusion. MMC was measured by reverse phase high pressure liquid chromatography (HPLC).


RESULTS
All IHHP procedures were successfully completed, blood loss was all controlled in 8 mL, and total operation time lasted (2.78+/-0.65) hours. All animals could tolerate the IHHP procedure, and survived. The mean leakage into the systemic circulation during perfusion was 2.63%, and 7.75% during the total procedure. In IHHP group maximal plasma concentration (C(max)) of hepatic circulation was (5.108+/-1.592) mg/L, C(max) of systematic circulation was (0.110+/-0.057) mg/L. In TAI group, Cmax of hepatic vein was (0.730 +/-0.362) mg/L, C(max) of systematic circulation (2.690+/-0.762) mg/L (P<0.01).


CONCLUSIONS
IHHP technique is feasible and leakage is relatively low, thus providing a reasonable basis for IHHP with balloon catheter technique.
Wang
Xiao dong
Xd
Department of Interventional Therapy, Beijing Cancer Hospital, Peking University School of Oncology, Beijing Institute for Cancer Research, Beijing 100036, China.
Yang
Ren jie
Rj
Sun
Hong liang
Hl
Zhang
Hong zhi
Hz
D000818:Animals; D002404:Catheterization / Q000379:methods*; D015687:Cell Hypoxia; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000295:instrumentation / Q000379:methods*; D005260:Female; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D011817:Rabbits; D011897:Random Allocation