Development of an extracorporeal liver support system: initial results

A pilot study was undertaken to determine the feasibility of extracorporeal normothermic perfusion of the porcine liver. Seven donor hepatectomies were performed in small 10 kg pigs and the livers were placed in a perfusion cassette of the author's design. Four perfusions were technical failures. Three successful perfusions had several factors in common: hepatic artery inflow roller pump, prompt "pinking up" of the perfused liver, a centrifugal vena cava outflow pump with partial diversion of the outflow into the portal vein with the remaining outflow returned to the anesthetized animal, and production of bile during the perfusion experiment. Successful perfusions lasted 50, 65, and 90 minutes.