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Related Experiment Videos

Support perfusion for liver transplantation.

D J Gifford1

  • 1Cambridge Perfusion Services, Department of Clinical Perfusion, Papworth Hospital, UK.

Perfusion
|January 1, 1991
PubMed
Summary

This study details the use of cardiopulmonary bypass in liver transplantation at Addenbrooke's Hospital. The technique supports high-risk adult liver recipients during the anhepatic phase, ensuring circulatory stability.

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Area of Science:

  • Cardiovascular Surgery
  • Hepatobiliary Surgery
  • Transplant Surgery

Background:

  • Addenbrooke's Hospital has performed liver transplants since 1968.
  • Bypass techniques have been intermittently used since 1977.
  • In 1990, 38% of adult liver transplants required bypass, with an additional 25% on standby.

Purpose of the Study:

  • To describe the criteria and methods for using bypass in high-risk adult liver recipients.
  • To detail the surgical cannulation and bypass system utilized.
  • To highlight the benefits of bypass for patient management during liver transplantation.

Main Methods:

  • Selection of high-risk adult liver recipients based on surgical and anesthetic criteria.
  • Placement of cannulae in jugular and/or brachial veins for volume replacement.
  • Femoral and portal vein cannulation for splanchnic venous drainage to a heparin-coated Biomedicus bypass system.

Main Results:

  • Bypass provides flows of 1.5 to 2.5 liters per minute.
  • Modest perfusion pressures (around 120mmHg) are maintained.
  • Adequate surgical venous decompression and circulatory support are achieved during the anhepatic phase.

Conclusions:

  • The described bypass technique effectively supports high-risk adult liver transplant recipients.
  • This method ensures hemodynamic stability and facilitates surgical venous decompression.
  • The routine use of bypass enhances patient benefit and minimizes risk in complex liver transplant cases.

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