[Utilization of veno-venous bypass in orthotopic liver transplantation].

AIMS

The aim of the present study was to evaluate the hemodynamic effects of venovenous bypass (VVB) and its possible protective action during the clamping of the hepatic vessels carried out in the anhepatic phase of the orthotopic liver transplantation.

PATIENTS AND METHODS

Forty-one liver transplant patients, 15 of whom were operated with VVB, were studied. VVB consisted of a bridge from the primitive iliac veins and the portal vein to the left axillary vein. The hemodynamic, metabolic and biologic variables as well as the components of reposition and the drugs administered were measured. The results obtained in both groups were statistically compared and analyzed.

RESULTS

During the anhepatic phase the values of cardiac output did not modify in the patients operated with VVB, while these values significantly decreased in other patients. Peripheral resistances increased less in the VVB group. During the reperfusion phase there were no significant differences between the hemodynamic parameters of either group. The decrease in temperature during the anhepatic phase was significantly greater in the VVB group.

CONCLUSIONS

Venovenous bypass offers greater hemodynamic stability during the anhepatic phase of orthotopic liver transplantation.