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Assessment of right liver graft perfusion effectiveness between one and two-catheter infusion methods.

Jung BH, Hwang S, Ha TY, Song GW, Jung DH, Kim KH, Ahn CS, Moon DB, Park GC, Kang SH, Yoon YI, Lee SG - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: In this study, we intended to assess the effectiveness of right liver graft perfusion methods through comparison of different infusion catheters.At bench experiment, the infusion flow rate and infusion pressure were 3.3 ml/sec and 1.9 cmH20 in one blood transfusion catheter group, and 11.7 ml/sec and 3.1 cmH20 in single transurethral resection of prostate irrigation catheter group, and 6.6 ml/sec and 2.0 cmH20 in two blood transfusion catheters group, respectively.Large size of right liver grafts seems to be its good indication.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Conventional graft perfusion method using one small-caliber catheter takes a relatively long time for right liver graft perfusion, thus some modification is needed. In this study, we intended to assess the effectiveness of right liver graft perfusion methods through comparison of different infusion catheters.

Methods: The study consisted of two parts including one bench experiment to obtain data of hydraulic infusion and one clinical trial of 40 cases on graft perfusion with one- versus two-catheter infusion methods. These two graft infusion methods were compared in terms of the perfusion time and washing-out efficiency.

Results: At bench experiment, the infusion flow rate and infusion pressure were 3.3 ml/sec and 1.9 cmH20 in one blood transfusion catheter group, and 11.7 ml/sec and 3.1 cmH20 in single transurethral resection of prostate irrigation catheter group, and 6.6 ml/sec and 2.0 cmH20 in two blood transfusion catheters group, respectively. In clinical trial with 40 right liver grafts, two-catheter group had a shorter graft portal perfusion time for the first 2 L of histidine-tryptophan-ketoglutarate (HTK) solution than the conventional one-catheter group (375±25 seconds vs. 662±34 seconds; p=0.001) and a lower rate of incomplete blood washing-out after the initial 2 L portal perfusion (40% vs. 85%; p=0.03).

Conclusions: The two-catheter infusion method appears to be more effective than the conventional one-catheter infusion method for right liver graft perfusion at the back table. Large size of right liver grafts seems to be its good indication.

No MeSH data available.


Comparison of perfusion time (bars with vertical lines) and proportion of incomplete perfusion (bars with transverse lines) for 2 L infusion of HTK solution between one- and two-catheter infusion methods.
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Figure 3: Comparison of perfusion time (bars with vertical lines) and proportion of incomplete perfusion (bars with transverse lines) for 2 L infusion of HTK solution between one- and two-catheter infusion methods.

Mentions: In the two-catheter infusion group (n=20), two catheters were concurrently inserted into the confluence of the right anterior and posterior portal vein stumps or separately inserted into these sectoral portal vein stumps. The mean graft weight was 681±78 g (p=0.46 vs. the one-catheter group) and the graft-recipient weight ratio was 1.05±0.89 (p=0.95 vs. the one-catheter group). Graft portal perfusion required 375±25 seconds for the first 2 L (p=0.001 vs. the one-catheter group) and 2-5 minutes for the next 0.5-1 L infusion. On additional test irrigation after initial 2 L infusion, blood-tinged perfusate drained from the portal vein in 8 of the 20 right liver grafts (40%) (p=0.03 vs. control group) (Fig. 3). In addition to the initial portal perfusion, a total of 0.5-1 L perfusate was needed to clear out the graft blood.


Assessment of right liver graft perfusion effectiveness between one and two-catheter infusion methods.

Jung BH, Hwang S, Ha TY, Song GW, Jung DH, Kim KH, Ahn CS, Moon DB, Park GC, Kang SH, Yoon YI, Lee SG - Korean J Hepatobiliary Pancreat Surg (2014)

Comparison of perfusion time (bars with vertical lines) and proportion of incomplete perfusion (bars with transverse lines) for 2 L infusion of HTK solution between one- and two-catheter infusion methods.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492314&req=5

Figure 3: Comparison of perfusion time (bars with vertical lines) and proportion of incomplete perfusion (bars with transverse lines) for 2 L infusion of HTK solution between one- and two-catheter infusion methods.
Mentions: In the two-catheter infusion group (n=20), two catheters were concurrently inserted into the confluence of the right anterior and posterior portal vein stumps or separately inserted into these sectoral portal vein stumps. The mean graft weight was 681±78 g (p=0.46 vs. the one-catheter group) and the graft-recipient weight ratio was 1.05±0.89 (p=0.95 vs. the one-catheter group). Graft portal perfusion required 375±25 seconds for the first 2 L (p=0.001 vs. the one-catheter group) and 2-5 minutes for the next 0.5-1 L infusion. On additional test irrigation after initial 2 L infusion, blood-tinged perfusate drained from the portal vein in 8 of the 20 right liver grafts (40%) (p=0.03 vs. control group) (Fig. 3). In addition to the initial portal perfusion, a total of 0.5-1 L perfusate was needed to clear out the graft blood.

Bottom Line: In this study, we intended to assess the effectiveness of right liver graft perfusion methods through comparison of different infusion catheters.At bench experiment, the infusion flow rate and infusion pressure were 3.3 ml/sec and 1.9 cmH20 in one blood transfusion catheter group, and 11.7 ml/sec and 3.1 cmH20 in single transurethral resection of prostate irrigation catheter group, and 6.6 ml/sec and 2.0 cmH20 in two blood transfusion catheters group, respectively.Large size of right liver grafts seems to be its good indication.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Conventional graft perfusion method using one small-caliber catheter takes a relatively long time for right liver graft perfusion, thus some modification is needed. In this study, we intended to assess the effectiveness of right liver graft perfusion methods through comparison of different infusion catheters.

Methods: The study consisted of two parts including one bench experiment to obtain data of hydraulic infusion and one clinical trial of 40 cases on graft perfusion with one- versus two-catheter infusion methods. These two graft infusion methods were compared in terms of the perfusion time and washing-out efficiency.

Results: At bench experiment, the infusion flow rate and infusion pressure were 3.3 ml/sec and 1.9 cmH20 in one blood transfusion catheter group, and 11.7 ml/sec and 3.1 cmH20 in single transurethral resection of prostate irrigation catheter group, and 6.6 ml/sec and 2.0 cmH20 in two blood transfusion catheters group, respectively. In clinical trial with 40 right liver grafts, two-catheter group had a shorter graft portal perfusion time for the first 2 L of histidine-tryptophan-ketoglutarate (HTK) solution than the conventional one-catheter group (375±25 seconds vs. 662±34 seconds; p=0.001) and a lower rate of incomplete blood washing-out after the initial 2 L portal perfusion (40% vs. 85%; p=0.03).

Conclusions: The two-catheter infusion method appears to be more effective than the conventional one-catheter infusion method for right liver graft perfusion at the back table. Large size of right liver grafts seems to be its good indication.

No MeSH data available.