Arias J, Aller M A, Lorente L, Rodriguez J C, Fernández X, Brandau D, Durán H
I Cátedra de Patología Quirúrgica, Hospital Universitario San Carlos, Universidad Complutense de Madrid, Spain.
Int Surg. 1990 Apr-Jun;75(2):78-83.
In hepatic preservation by simple perfusion and hypothermic storage, a portal and hepatic washout before revascularization would avoid receptor hyperkaliema. In this report we study the effectiveness of this washout with Haemaccel at room temperature. Large-White pigs were used and eight livers were perfused "in situ" via the portal wein with Hartmann's solution containing 10,000 IU of heparin at 4 degrees C, and afterwards, via portal and arterial routes with C2 solution at 4 degrees C. After a cold ischemia time of less than 31/2 hours a liver washout via the portal vein and hepatic artery with Haemaccel before portal revascularization was done. The high concentrations of glucose, K+, GOT, GPT and LDH in the effluents obtained during the washout are attributed to Haemaccel hyperosmolarity. A portal and arterial hepatic washout associated with free drainage of the first 50-100 ml of portal venous blood after hepatic portal revascularization through the infrahepatic inferior vena cava (IH-IVC), prevents hyperkaliemia from occurring after a portal and arterial revascularization in the orthotopic liver transplant (OLT) in pigs.
在通过简单灌注和低温保存进行肝脏保存时,血管再通前进行门静脉和肝脏冲洗可避免受体高钾血症。在本报告中,我们研究了室温下用贺斯进行这种冲洗的效果。使用大白猪,8个肝脏在4℃下经门静脉用含10000IU肝素的哈特曼溶液进行“原位”灌注,之后在4℃下经门静脉和动脉途径用C2溶液灌注。在冷缺血时间少于3.5小时后,在门静脉再通前经门静脉和肝动脉用贺斯进行肝脏冲洗。冲洗过程中流出液中高浓度的葡萄糖、钾离子、谷草转氨酶、谷丙转氨酶和乳酸脱氢酶归因于贺斯的高渗性。门静脉和动脉肝脏冲洗,以及肝门静脉再通后最初50 - 100ml门静脉血经肝下下腔静脉自由引流,可防止猪原位肝移植(OLT)门静脉和动脉再通后发生高钾血症。