Kumagae T, Harada T, Furoi A, Kamimura R, Yoshida H, Taira A
Nihon Geka Gakkai Zasshi. 1986 Apr;87(4):418-22.
A simplified technique of the liver transplantation under hypothermia has been studied in dog. An immersion hypothermia was used in both the donor and the recipient. The temperature of the graft at excision was lowered to 20 degrees C with supplemental use of topical cooling. The temperature of the recipient was lowered at 27 degrees C when the transplantation was attempted. Chlorpromazine and dopamine were employed beneficially in hypothermia. No perfusion or irrigation of the graft was performed. The use of heparin was avoided. Anastomoses were carried out in turn of the proximal vena cava, portal vein, distal vena cava and the hepatic artery with a stem shaped aorta. Reperfusion was established after the completion of anastomosis between the proximal vena cava and portal vein. The anhepatic phase of the recipient was uneventfully lasted without heparinization. All dogs, 5 out of 11 without early surgical troubles survived more than 5 days. Immunosuppressive therapy was not employed except one which died of pneumonia on the 19th postoperative day. Histologically, these dogs were free from ischemic injury and/or thrombotic lesion throughout transplantation procedure.
已在犬身上研究了一种低温下肝移植的简化技术。供体和受体均采用浸泡式低温。切除时移植物的温度通过局部降温补充降至20℃。尝试移植时受体温度降至27℃。氯丙嗪和多巴胺在低温时有益。未对移植物进行灌注或冲洗。避免使用肝素。采用带主干状主动脉依次吻合近端腔静脉、门静脉、远端腔静脉和肝动脉。在近端腔静脉和门静脉吻合完成后建立再灌注。受体的无肝期在未肝素化的情况下平稳持续。11只犬中有5只无早期手术问题且存活超过5天。除1只在术后第19天死于肺炎外,均未采用免疫抑制治疗。组织学检查显示,这些犬在整个移植过程中均无缺血性损伤和/或血栓形成病变。