Biochyperhemical evaluation of isolated porcine liver system perfused with oxygenated blood by ECMO

目的：探讨肝脏灌注的最佳条件，以延长肝移植保存时间，避免原发性无功能或再灌注损伤。材料与方法：采用经门静脉至肝下IVC的静脉-静脉分流，经ECMO灌注氧合血21例。结扎下腔静脉上动脉和肝动脉后，取肝，在37℃乳酸林格液中继续灌注。结果：由于在整个实验过程中有一定数量的胆汁液排出，因此在12小时以上的氧合血灌注过程中，肝移植物的生物活性基本保持。然而，经门静脉充氧灌注可引起严重的代谢和生化问题。分别为低钠血症、代谢性酸中毒和高血糖症。

Aim : The optimal condition of liver perfusion was investigated in order to prolong the preservation time of liver graft and also to avoid primary non-function or re-perfusion injury.Materials and Methods : Twenty one porcine livers were purfused with oxygenated blood by ECMO, using venous-venous bypass via portal vein to infrahepatic IVC. After supra IVC and hepatic artery were ligated, thliver was harvested and kept on perfusing in 37℃ lactate Ringer solution.Results : Since some amount of bile juice was excreted throughout the experiment, biological activity of the liver grafts seem to be maintained essentially by meaning of perfusion with oxygenated blood for more than 12 hours. However, it was made clear that the oxygenated perfusion via portal vein be responsible for severe metabolic and biochemical problems. They were hyponatremia, metabolic asidosis and hyperglycemia which were resistant to insulin administration.