ObjectiveTo explore the application of extracorporeal venovenous bypass in orthotopic liver transplantation in pigs and to compare hemodynamic changes during operation of two different bypass ways. MethodsTwentyfive porcine orthotopic liver transplantations were performed and extracorporeal venovenous bypass was established during anhepatic phase through a catheter in portal vein (group A,n=16) or in splenic vein (group B,n=9).Hemodynamic changes were monitored continuously.ResultsFourteen recipients survived two days after operation (14/16) in group A while all survived in group B (9/9).Transient hemodynamic disturbance (MAP and CVP decreased,and HR increased) was monitored at both the beginning and the end of anhepatic stage in group A,while these parameters kept stable in group B (P＜0.05).ConclusionApplying venovenous bypass may stabilize recipients’ hemodynamics in porcines orthotopic liver transplantation,and splenic vein draining way has more advantages than portal vein.
ObjectiveTo study the early functional change of sinusoid endothelial cell after liver transplantation in rat, and to investigate the endothelia protective effect of prostaglandin E1(PGE1). MethodsRat orthotopic liver transplantation model was performed in “twocuff method”, grouped as follows: group A served as normal rat blank control, group B as operative control with normal donor, group C as experimental control with shock donor, and group D as experimental group with shock donor and PGE1 administration (n=8 in each group). Transplanted groups (referring to recipients without specific definition) were sacrificed 6 h after operation for blood taken to detect serum liver enzymes (ALT, LDH), malondialdehyde (MDA), nitric oxide (NO) and plasm endothelin (ET). Liver tissue was resected at the same time for standard pathologic examination. Comparison of the difference the results was made between groups. ResultsCold preservation time and anhepatic phase were similar in each group, (2±0.5) h and (15±3) min respectively. All survived 6 h after transplantation (8/8) in group B and D with a survival rate of 100%, only 5 survived 6 h after transplantation in group C (5/8) with a survival rate of 62.5%. Comparing with group C, blood ALT, LDH, MDA, ET decreased and NO increased significantly in group D (Plt;0.05). Marked histologic structural damage was observed in group C, while normal light microscope appearance was better preserved in group C and D. ConclusionMarked sinusoid endothelia injury occurs during liver transplantation. Concentration of serum NO and plasm ET well presents its function. PGE1 relieves endothelia injury by improving hemodynamics and stabilizing sinusoid endothelial cell plasma membrane.