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Related Experiment Video

Updated: Jun 16, 2025

Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
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Anesthesia-specific Protocol for Percutaneous Hepatic Perfusion Procedures.

Daniel A Nahrwold1, Jinhong Liu1, Navindra Doobay2

  • 1H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; University of South Florida Morsani College of Medicine, Tampa, FL.

Journal of Cardiothoracic and Vascular Anesthesia
|April 12, 2025
PubMed
Summary
This summary is machine-generated.

Percutaneous hepatic perfusion (PHP) offers a safe anesthetic approach for uveal melanoma liver metastases. Careful preoperative evaluation and intraoperative management are key to handling hemodynamic changes during this complex procedure.

Keywords:
anesthesiacoagulopathymelphalan hydrochloridepercutaneous hepatic perfusionuveal melanomavasopressorsvenovenous bypass

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Area of Science:

  • Hepatology
  • Oncology
  • Anesthesiology

Background:

  • Percutaneous hepatic perfusion (PHP) is increasingly used for liver metastases from uveal melanoma.
  • The authors' institution has extensive experience, performing over 200 PHP procedures.

Purpose of the Study:

  • To evaluate the anesthetic safety profile of percutaneous hepatic perfusion (PHP) procedures.
  • To highlight the challenges and management strategies for anesthetic care during PHP.

Main Methods:

  • Review of anesthetic management for over 200 percutaneous hepatic perfusion (PHP) procedures.
  • Analysis of intraoperative hemodynamic fluctuations and postoperative complications.

Main Results:

  • PHP procedures have a favorable anesthetic safety profile.
  • Significant blood pressure and heart rate fluctuations occur during chemotherapy delivery and bypass, often requiring vasopressors.
  • Postoperative management includes blood products for coagulopathy and diuretics for fluid overload.
  • Anesthesia- and procedure-associated complications are rare but can be severe.

Conclusions:

  • Percutaneous hepatic perfusion (PHP) is generally well-tolerated in patients with uveal melanoma liver metastases.
  • Anesthesia-specific protocols are crucial for successful and safe PHP procedures.
  • Proactive management of hemodynamic instability and postoperative complications is essential.