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EFFECTS OF TOTAL HEPATECTOMY: STUDIES IN A PORCINE MODEL
Author(s) -
Thompson J. F.,
Bell R.,
Bookallil M. J.,
Sheil A. G. R.
Publication year - 1994
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1994.tb02287.x
Subject(s) - medicine , hepatectomy , inferior vena cava , extracorporeal , hemodynamics , liver transplantation , surgery , central venous pressure , portacaval shunt , cardiology , anesthesia , portal hypertension , transplantation , blood pressure , cirrhosis , heart rate , resection
The effects of total hepatectomy in a porcine model were studied. A portacaval shunt was constructed prior to hepatectomy, and the excised segment of inferior vena cava was replaced with a Dacron graft as soon as the liver had been removed. While the vena cava was clamped, venous return from the lower body to the heart was maintained using an extracorporeal veno‐venous bypass system. The results of the study revealed that surprisingly few haemodynamic, biochemical or coagulation disturbances occur within the first 5 h following total hepatectomy in the pig, an animal with remarkably close anatomical and physiological similarities to man. In the anhepatic period which follows total hepatectomy during clinical liver transplantation, the situation is more complex, because pre‐existing liver disease and portal hypertension, as well as major blood loss, often provide other reasons for metabolic and haemodynamic instability and coagulation disorders. The possible relevance of the findings in this large animal model to events that occur following total hepatectomy in the clinical situation is discussed.