Wang Xiao dong, Yang Ren jie, Sun Hong liang, Zhang Hong zhi
Department of Interventional Therapy, Beijing Cancer Hospital, Peking University School of Oncology, Beijing Institute for Cancer Research, Beijing 100036, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2008 Apr;40(2):200-4.
To establish a simplified isolated hypoxic hepatic perfusion (IHHP) technique, and to provide basis for IHHP using balloon occlusion catheter technique.
Twelve rabbits were randomly divided into two groups: IHHP group and transcatheter arterial infusion (TAI) group. Technique of IHHP: the aorta above celiac axis was clamped, the retrohepatic inferior vena cava (IVC) was clamped above and below the level of the hepatic veins and an outflow catheter was introduced into this isolated segment via a femoral vein. The inflow catheter was introduced into the gastroduodenal artery, and common hepatic artery was clamped. The perfusate which contained Mitomycin C (MMC, 0.5 mg/kg) were perfused into hepatic artery, the hepatic outflow was draw out, and then perfused through hepatic artery again, the perfusion continued for 15 minutes. At the end of the IHHP procedure a washout was performed with 50 mL hespander for 5 minutes. TAI group method: Transarterial infusion was performed via hepatic artery using the same dose of MMC. Blood (2 mL) was sampled from hepatic vein and peripheral vein at multiple time points from the start of perfusion. MMC was measured by reverse phase high pressure liquid chromatography (HPLC).
All IHHP procedures were successfully completed, blood loss was all controlled in 8 mL, and total operation time lasted (2.78+/-0.65) hours. All animals could tolerate the IHHP procedure, and survived. The mean leakage into the systemic circulation during perfusion was 2.63%, and 7.75% during the total procedure. In IHHP group maximal plasma concentration (C(max)) of hepatic circulation was (5.108+/-1.592) mg/L, C(max) of systematic circulation was (0.110+/-0.057) mg/L. In TAI group, Cmax of hepatic vein was (0.730 +/-0.362) mg/L, C(max) of systematic circulation (2.690+/-0.762) mg/L (P<0.01).
IHHP technique is feasible and leakage is relatively low, thus providing a reasonable basis for IHHP with balloon catheter technique.
建立一种简化的孤立性缺氧肝灌注（IHHP）技术，为使用球囊阻塞导管技术进行IHHP提供依据。
将12只兔子随机分为两组：IHHP组和经导管动脉灌注（TAI）组。IHHP技术：夹闭腹腔干轴上方的主动脉，在肝静脉水平上下夹闭肝后下腔静脉（IVC），并通过股静脉将流出导管插入该孤立段。将流入导管插入胃十二指肠动脉，并夹闭肝总动脉。将含有丝裂霉素C（MMC，0.5mg/kg）的灌注液灌注到肝动脉中，引出肝流出液，然后再次通过肝动脉灌注，灌注持续15分钟。在IHHP操作结束时，用50mL羟乙基淀粉冲洗5分钟。TAI组方法：经肝动脉进行经动脉灌注，使用相同剂量的MMC。从灌注开始的多个时间点从肝静脉和外周静脉采集血液（2mL）。通过反相高压液相色谱（HPLC）测量MMC。
所有IHHP操作均成功完成，失血量均控制在8mL以内，总手术时间为（2.78±0.65）小时。所有动物均能耐受IHHP操作并存活。灌注期间平均漏入体循环的量为2.63%，整个操作过程中为7.75%。IHHP组肝循环的最大血浆浓度（C(max)）为（5.108±1.592）mg/L，体循环的C(max)为（0.110±0.057）mg/L。TAI组肝静脉的Cmax为（0.730±0.362）mg/L，体循环的C(max)为（2.690±0.762）mg/L（P<0.01）。
IHHP技术可行且渗漏率相对较低，从而为使用球囊导管技术进行IHHP提供了合理依据。
