Sabaté A, Figueras J, Segura R, Fuentelsanz T, Camprubí I, Jaurrieta E
Servicio de Anestesiá y Reanimacion, Ciudad Sanitaria de Bellvitge-Prínceps d'Espanya, L'Hospitalet de Llobregat, Barcelona.
Rev Esp Anestesiol Reanim. 1993 Jan-Feb;40(1):12-6.
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.
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.
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.
Venovenous bypass offers greater hemodynamic stability during the anhepatic phase of orthotopic liver transplantation.
本研究旨在评估静脉-静脉转流（VVB）在原位肝移植无肝期肝血管阻断期间的血流动力学效应及其可能的保护作用。
对41例肝移植患者进行了研究，其中15例采用VVB进行手术。VVB由一条从髂总静脉和门静脉至左腋静脉的桥接管道组成。测量了血流动力学、代谢和生物学变量以及复位组件和所用药物。对两组获得的结果进行了统计学比较和分析。
在无肝期，接受VVB手术的患者心输出量值未发生改变，而其他患者的心输出量值显著下降。VVB组外周阻力增加较少。在再灌注期，两组的血流动力学参数之间无显著差异。VVB组在无肝期体温下降明显更大。
静脉-静脉转流在原位肝移植无肝期提供了更大的血流动力学稳定性。
