[Experimental studies on extracorporeal liver perfusion.--Development and evaluation of an improved circuit (author's transl)]. 1978

N Kawanishi

Clinical application of the extracorporeal liver perfusion has been rather limited mainly because of cumbersome procedure, not infrequent circulatory insufficiency due to large priming volume, and bleeding tendency due to hepatic insufficiency itself and heparinization, which are inherent with most of the currently available systems. A circuit was developed which employs siliconized tubings to eliminate heparinization. The liver is gravity perfused added with arterial pressure by utilizing A-V type blood access, thus eliminating the blood pump and oxygenator. A heat exchanger is eliminated by placing the liver in a moist liver chamber kept at 30 degrees C. Feasibility of the circuit was confirmed by 5 in vivo runs with healthy mongrel dogs who tolerated the procedure well. This circuit was further evaluated in dogs with acute hepatic failure induced by portacaval anastomosis and subsequent ligation of the proper hepatic artery 48 hours later. They were connected to the circuit when convulsion developed. Along with clinical observation, biochemical analysis were performed for samples obtained at the inlet (In-blood) and the outlet (Out-blood) of the liver chamber. Oxygen consumption with carbon dioxide production by the liver was confirmed in previous control experiment. Although temporarily, all animals showed recovery from convulsion. Ammonia level was invariably lower in Out-blood than in In-blood by approximately 70 gamma/dl. Blood sugar level was always higher in Out-blood by 40-70 mg/dl than in In-blood. Other parameters such as bilirubin, total protein, GOT and GPT levels were not significantly different. Technical feasibility and acceptable performance of the system were established in this study and its clinical evaluation is warranted.

UI MeSH Term Description Entries
D008099 Liver A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances. Livers
D008107 Liver Diseases Pathological processes of the LIVER. Liver Dysfunction,Disease, Liver,Diseases, Liver,Dysfunction, Liver,Dysfunctions, Liver,Liver Disease,Liver Dysfunctions
D010477 Perfusion Treatment process involving the injection of fluid into an organ or tissue. Perfusions
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005069 Evaluation Studies as Topic Works about studies that determine the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. Critique,Evaluation Indexes,Evaluation Methodology,Evaluation Report,Evaluation Research,Methodology, Evaluation,Pre-Post Tests,Qualitative Evaluation,Quantitative Evaluation,Theoretical Effectiveness,Use-Effectiveness,Critiques,Effectiveness, Theoretical,Evaluation Methodologies,Evaluation Reports,Evaluation, Qualitative,Evaluation, Quantitative,Evaluations, Qualitative,Evaluations, Quantitative,Indexes, Evaluation,Methodologies, Evaluation,Pre Post Tests,Pre-Post Test,Qualitative Evaluations,Quantitative Evaluations,Report, Evaluation,Reports, Evaluation,Research, Evaluation,Test, Pre-Post,Tests, Pre-Post,Use Effectiveness
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013552 Swine Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA). Phacochoerus,Pigs,Suidae,Warthogs,Wart Hogs,Hog, Wart,Hogs, Wart,Wart Hog
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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