Bornscheuer A, Mahr K H, Oldhafer K J, Höltje M, Szabo M, Kirchhoff S K, Seitz W, Kirchner E
Abt. I, Medizinischen Hochschule Hannover.
Anaesthesiol Reanim. 1997;22(5):116-20.
The isolated hyperthermic liver perfusion with mitomycin C presents a new technique of regional therapy for irresectable liver tumours. The advantage is a high local concentration of the antitumour agent with reduced systemic side-effects. Isolated hyperthermic liver perfusion is an extensive surgical procedure requiring a veno-venous bypass and a heart-lung machine. Disturbances affecting the base-acid hemostasis, the coagulation system and the cardiocirculatory function can occur. To date, there has been little experience with this technique. The intraoperative changes during the isolated hyperthermic liver perfusion in our series were similar to those seen during orthotopic liver transplantation. In contrast to orthotopic liver transplantation, heparin is given during the anhepatic phase. The reperfusion after isolated hyperthermic liver perfusion was not complicated by severe cardiocirculatory changes. A decrease in body temperature was not observed probably due to the absence of cold, potassium-rich perfusate flowing into the systemic circulation. Two patients developed signs of a reperfusion syndrome within the first hour after reperfusion (decrease in peripheral systemic resistance).
丝裂霉素C隔离热灌注肝是一种针对不可切除性肝肿瘤的区域治疗新技术。其优势在于抗肿瘤药物局部浓度高且全身副作用减少。隔离热灌注肝是一种需要静脉-静脉转流和心肺机的大型外科手术。可能会出现影响酸碱平衡、凝血系统和心脏循环功能的紊乱。迄今为止，该技术的经验很少。我们系列中隔离热灌注肝术中的变化与原位肝移植术中所见相似。与原位肝移植不同，在无肝期给予肝素。隔离热灌注肝后的再灌注未出现严重心脏循环变化并发症。未观察到体温下降，可能是由于没有富含钾的冷灌注液流入体循环。两名患者在再灌注后第一小时内出现再灌注综合征体征（外周系统阻力降低）。
