Does hypothermic perfusion have beneficial effects for ischemic liver during extended hepatectomy with hepatic inflow occlusion of canine liver? A comparative study with topical cooling.

BACKGROUND/AIMS: The present study was designed to elucidate the effect of topical cooling and hypothermic perfusion in extended hepatectomy under hepatic inflow occlusion. Hypothermic perfusion has provided to have a protective effect on the ischemic liver. However, it has not been determined whether hypothermia or perfusion had salutary effects on the ischemic liver.

METHODOLOGY

Seventy-five percent of the liver was resected under hepatic inflow occlusion for 60 minutes in each adult mongrel dog. The animals were divided into three groups; no cooling group (n = 8), topical cooling group (n = 7) using ice slush and hypothermic perfusion group (n = 7). Blood from the hepatic vein was sampled for measurement of ALT, AST, LDH and purine nucleoside phosphorylase.

RESULTS

The seven-day survival in topical cooling group and hypothermic perfusion group was better compared with that in no cooling group. ALT, AST and LDH levels showed no significant differences among the groups. PNP levels were significantly lower in topical cooling group (p < 0.01) and hypothermic perfusion group (p < 0.05) than in no cooling group, but no significant differences between topical cooling group and hypothermic perfusion group.

CONCLUSIONS

In the hepatic ischemia for 60 minutes, hypothermic perfusion did not demonstrate markedly better effects compared with topical cooling.