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Hyperthermic isolation‐perfusion in vivo of the canine liver
Author(s) -
Skibba Joseph L.,
Condon Robert E.
Publication year - 1983
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19830401)51:7<1303::aid-cncr2820510721>3.0.co;2-d
Subject(s) - perfusion , ketone bodies , medicine , urea , in vivo , endocrinology , fissipedia , metabolism , biochemistry , chemistry , biology , microbiology and biotechnology
Regional hyperthermia (42°) was applied to the canine liver by isolation‐perfusion in order to demonstrate that dog survival and maintenance of hepatic functional integrity were possible. Flow to the liver, 1 ml/min/g, was provided by gravity to the portal vein at 2/3 total flow, and by pump to the hepatic artery at 1/3 total flow. After 1 hour perfusion at 37°, 4/6 dogs survived and 5/8 survived perfusion at 42°. Hypoglycemia contributed to the two deaths at 37° and one at 42°. After two‐hour perfusion at 37°, 5/5 dogs survived, and 3/5 survived at 42°. After four‐hour perfusion at 37°, 1/1 dog survived, and 1/1 survived at 42°. Hyperlactemia occurred during all perfusions, but plateaued at a level of 8–10 mM. Plasma SGPT, SGOT, or 5‐nucleotidase levels during and after perfusion were mildly elevated, but returned to normal within 4–7 days. Perfusate chemistries (lactate, pyruvate, glucose, urea, total amino acids, ketone bodies, and enzymes) were used as indicators of hepatic functional integrity. Lactate in the perfusate showed no significant differences ( P < 0.05) between 37 and 42°. Glucose increased in the perfusate during all perfusions. Urea synthesis occurred during all perfusions and was unchanged by a temperature of 42°. The total amino acid levels in the perfusate reflected endogenous proteolysis, which was unchanged at 42°. Ketone body production was increased during the two‐hour perfusions due to the addition of Intralipid to the perfusate. There were no significant differences in the perfusate enzyme levels at 37 and 42°. The data presented indicate that hepatic functional integrity can be maintained in the canine liver during isolation‐perfusion at 42°. Support of the dog during and after the temporary anhepatic state may be the crucial factor to survival. Thermotherapy by isolation‐perfusion of the liver could be useful for treating patients with cancer limited to the liver.