Venovenous bypass ahead of mobilization of the liver in orthotopic liver transplantation

摘要

BACKGROUND: To evaluate feasibility and safety of venovenous bypass prior to mobilization of the liverduring orthotopic liver transplantation (OLT).METHODS: Fifty-four patients were classified into two groups. Group A consisted of 23 patientsreceiving OLT with classical venovenous bypass. Group B consisted of 31 patients who received amodified-procedure: venovenous bypass ahead of the mobilization of the liver during ULT. The blood loss,duration of venovenous bypass, cold ischemia time, anhepatic phase, and transfusion during operation inthe two groups were compared. Complications after the operation were also compared between the twogroups.RESULTS: The duration of venovenous bypass and cold ischemia time in group A were longer than thosein group B [(99.78±21.36 min) vs (96.32±22.25 min) and (484.78±134.01 min) vs (443.15±85.27 min)]. The anhepatic phase lasted for about 100 min averagely in the two groups. The volumes ofblood loss and transfusion during the operation were larger in group A than in group B [(5096±4243 ml)vs (1726±1125 ml) and (3676±2938.74 ml) vs (1217.69±829.72 ml)]. Postoperative complicationsoccurred in 26 patients of group A and in 19 patients of group B.CONCLUSION: This modified-procedure or venovenous bypass ahead of mobilization of the liver in OLTcan reduce the blood loss during OLT and the incidence of postoperative complications withoutprolongation of the anhepatic phase and duration of venovenous bypass.