[Orthotopic liver graft with aortic clamping. Experimental study in dogs (author's transl)]

Orthotopic liver transplants were conducted in 15 dogs, with aortic clamping during the anhepatic time of the operation and without venous shunting. Aortic clamping lasted for between 30 and 42 minutes. Immunosuppressant treatment was not given. Eight dogs died within 2 hours after the operation, 5 from haemorrhage and 3 accidentally. Seven animals survived for between 6 hours and 11 days: 3 died within 24 hours from haemorrhage, 2 from hepatic failure between the 2nd and 3rd day. One animal died on the 7th day from an acute intestinal invagination, the dog surviving for the longest period eventually dying after rejection of the transplant. These results demonstrate, as in other reported series, that the most frequent cause of death is the haemorrhagic diathesis, probably as a result of poor graft conservation. Dogs tolerate the supracoeliac aorta clamp both from the renal and intestinal points of view ; spinal cord tolerance to the ischaemia is less evident as paraplegia of the hindquarters was noted in one animal in the group. Aortic clamping considerably reduces operative time, as it avoids the need to construct a mesentericocaval anastomosis and a femorojugular shunt. It also avoids splanchnic blood sequestration and the risk of reducing cardia filling during clamping of the inferior vena cava.