부분 간이식을 시행한 실험견의 이식전후의 혈역동적 변화

Abstract

In order to compare the hemodynamic changes that occurred during the conventional whole liver transplantation, we performed piggyback type segmental liver transplantation in 6 adult dogs and monitored hemodynamic changes during the whole operative procedures. During the anhepatic period, only left hepatic vein was clamped but the influx of the inferior vena caval flow was completely preserved. The mean arterial pressure, cardiac output and pulmonary flow were decreased moderately but restored slowly after declamping of the portal vein. But we couldn't observe post-reperfusion syndrome in this procedure. Arterial blood gas analysis showed decreased level of potassium and ionized calcium during the anhepatic period with severe acidosis but slowly corrected after declamping of portal vein. The prolonged aPTT was continued during the operation but should consider the usage of the heparin during the vascular clamp. Therefore, we believe that piggyback procedure seems to minimize the hemodynamic changes during the segmental liver trandplantation. To detect other factors that disturb the coagulation mechanism, coagulation factor study will be necessary.