The management of ambi-operation for orthotopic liver transplantation in Chinese inbred miniature porcine

doi:10.3877/cma.j.issn.1674-0793.2007.01.003

Abstract

Abstract:

Objective

To summarize the feature of perioperative management in the orthotopic liver transplantations （OLTs） in miniature porcine，and to establish the matural and stable models.

Methods

8pous preliminary experiments and 18pous experiments of OLTs were performed without veno-venous bypass （VVB） in Chinese inbred miniature porcine in order to observe hemodynamics and blood changes，and improve perioperative management.

Result

The mean operation time was（179.6±14.3）min，and the mean anhepatic phase time was（27.3±3.4）min in our 18 OLTs.Dramatic hemodynamic and metabolism changes were identified during anhepatic phase.The one-week survival rate was 88.9%.Experiment group discarded urine after 3 ～5 hours and had normal eating after 3 days.

Conclusion

Decreasing the operation time and stability of hemodynamics in anhepatic phase is the key problem in OLTs without VVB.

Key words: Orthotopic liver transplantation, Surgical technique, Perioperative management, Inbred miniature porcine

Ming-xin PAN, Fan-dong KONG, Ai-hui LI, Jin-min XIE, Yi ZHANG, Ling WANG, Yi GAO. The management of ambi-operation for orthotopic liver transplantation in Chinese inbred miniature porcine[J]. Chinese Archives of General Surgery(Electronic Edition), 2007, 01(01): 9-11.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2007.01.003

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2007/V01/I01/9

Figures/Tables 1

参数		例数	无肝前期	无肝期	新肝再灌注期	手术结束
HR（bpm）	$\overset{ˉ}{x}$	18	83.83 9.75	144.05^△	144.72^△	139.06△
	s			6.49	8.40	8.53
MAP（mmhg）	$\overset{ˉ}{x}$	18	92.44 6.61	48.17^△	76.00^△#	86.39^#*
	s			10.15	8.15	11.85
CVP（cmH₂O）	$\overset{ˉ}{x}$	18	5.17 0.99	1.56^△	4.78#	5.78^*
	s			1.15	1.66	1.22
pH	$\overset{ˉ}{x}$	18	7.39 0.02	7.32^△	7.25^△#	7.38^#*
	s			0.05	0.06	0.03
K⁺（mmol/L）	$\overset{ˉ}{x}$	18	4.27 0.30	4.61^△	5.32^△#	4.68^△*
	s			0.57	0.45	0.37
BE（mmol/L）	$\overset{ˉ}{x}$	18	0.61 2.42	-3.33^△	-4.11^△#	-1.06^#*
	s			2.38	2.25	2.13

参数		例数	无肝前期	无肝期	新肝再灌注期	手术结束
HR（bpm）	$\overset{ˉ}{x}$	18	83.83 9.75	144.05^△	144.72^△	139.06△
	s			6.49	8.40	8.53
MAP（mmhg）	$\overset{ˉ}{x}$	18	92.44 6.61	48.17^△	76.00^△#	86.39^#*
	s			10.15	8.15	11.85
CVP（cmH₂O）	$\overset{ˉ}{x}$	18	5.17 0.99	1.56^△	4.78#	5.78^*
	s			1.15	1.66	1.22
pH	$\overset{ˉ}{x}$	18	7.39 0.02	7.32^△	7.25^△#	7.38^#*
	s			0.05	0.06	0.03
K⁺（mmol/L）	$\overset{ˉ}{x}$	18	4.27 0.30	4.61^△	5.32^△#	4.68^△*
	s			0.57	0.45	0.37
BE（mmol/L）	$\overset{ˉ}{x}$	18	0.61 2.42	-3.33^△	-4.11^△#	-1.06^#*
	s			2.38	2.25	2.13

References 7

1	Schon MR，Kollmar O，Wolf S，et al.Liver transplantation after organ preservation with normothermic extracorporeal perfusion.Ann Surg，2001，233（1）：114～123
2	Nowak G，Ungerstedt J，Wernerman J，et al.Metabolic changes in the liver graft monitored continuously with microdialysis during liver transplantation in a pig model.Liver Transpl，2002，8（5）：424～432
3	Saad S，Minor T，Kotting M，et al.Extention of tolerance of pcrcine liver by cold preservation including postconditioning with gaseous oxygen.Transplantation，2001，71（4）：498～502
4	潘明新，李爱辉，高毅，等.中国小型猪原位肝移植的实验研究.南方医科大学学报，2006，26（7）：1069～1070
5	Nakata-Y，Sato-M，Watanabe-Y.Antraoperative fluid requirements during porcine liver transplantation.Transplant，2000，32（7）：2338～2339
6	陈知水，曾凡军，叶启发，等.经典式原位肝移植术弃用静脉转流的经验总结.外科理论与实践，2002，7（2）：131～133
7	卿德科，韩本立.小型猪非转流式原位肝移植无肝期控制性补液.贵阳医学院学报，2005，30（3）：217～222

[1]	Xingyu Luo, Zhe Yang, Shusen Zheng. Exploring the classification of portal vein thrombosis and portal vein reconstruction strategies in liver transplantation [J]. Chinese Journal of Transplantation(Electronic Edition), 2023, 17(06): 372-380.
[2]	Chunyan Jiang, Gang Zhao, Guoping Zhu, Qinghui Fu, Jianhua Wei. Preoperative clinical application of right heart floating catheter examination and nursing strategy analysis for heart transplant recipient [J]. Chinese Journal of Transplantation(Electronic Edition), 2023, 17(03): 164-168.
[3]	Wenhe Yang, Liang Zhang, Fushan Xue, Zhijun Zhu. Anesthetic management of pediatric patients with hereditary tyrosinemia type 1 undergoing living-donor liver transplantation [J]. Chinese Journal of Transplantation(Electronic Edition), 2021, 15(03): 161-165.
[4]	Chong Wang, Dongjie Yan, Changfan Gong, Yi Han. Surgical principles and techniques of three-dimensional reconstruction assisted thoracoscopic pleural decortication for the treatment of encapsulated empyema [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(03): 164-167.
[5]	Cuirong Lei, Lifang Ma, Dongling Zou. Minimally invasive surgical technique for excising hypertrophic lymph nodes [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2023, 16(05): 299-303.
[6]	Jian Wang, Chuanxin Yang. Difficulties and focus of surgical standard treatments for gallbladder cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(02): 137-141.
[7]	Xishan Wang. Limitations of randomized controlled trial in surgery [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(05): 457-461.
[8]	. Expert consensus on perioperative management of day surgery for hip and knee arthroplasty in China [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(06): 321-332.
[9]	Bingzhi Huang, Nannan Chen. Risk factors for pneumonia in patients with hip fractures after surgery [J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(06): 338-344.
[10]	Xingjian Yang, Shousen Wang, Wei Sun. Concept and technical progress of presidential cranioplasty in children [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(04): 249-252.
[11]	Gao Shan, Youjing Dong. Advances in research of frailty in elderly surgical patients [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(03): 343-348.
[12]	Liqun Shang, Shaolu Zhang, Zhigang Qu, Guang Wu. Application of single-port video-assisted thoracoscopy in emergency thoracic surgery during novel coronavirus pneumonia pandemic: advantages and perioperative management [J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(06): 452-455.
[13]	Wentao Fang. From refined technology to redefining ideology—introduction to the Issue 1 of Chinese Journal of Thoracic Surgery (Electronic Edition) in 2022 [J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2022, 09(02): 109-110.
[14]	Qichen Luo, Yalan Li. Clinical progress of residual neuromuscular block in obese patients [J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(01): 61-65.
[15]	Chinese Society of Diabetes and Bariatric Surgery,Chinese Research Hospital Association. Chinese expert consensus on enhanced recovery after surgery principles in bariatric and metabolic surgery (2021 edition) [J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(03): 141-145.

Please choose a citation manager

Content to export