CADAVERIC LIVER PROCUREMENT USING AORTIC PERFUSION ONLY

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Abstract

Background:

To test the effectiveness of a simpler surgical technique for cadaveric liver procurement for liver transplantation, a prospective randomized study was carried out between August 1994 and December 1995, to compare aortic perfusion only (APO) for flush-preservation of the liver with the conventional combined aortic and portal perfusion (APP) technique.

Methods:

Forty multiple organ donors were enrolled with 20 in each arm of the trial. Donor parameters (age, bodyweight, liver function tests), surgeons performing the operations, the involvement of other procurement teams and the total ischaemic times were similar in the two groups. The liver recipients had a wide range of native liver pathology but were of similar age, sex and bodyweight in the two groups.

Results:

The mean procurement operation times for the APO and APP groups were 126.7 ± 38.6 and 137.8 ± 55.9 min, respectively (P = ns). The perfusion took longer to complete in the APO group (10.2 ± 1.7 vs 7.2 ± 1.4 min (APP), P < 0.001). The liver temperature fell to its lowest level (12.5 ± 3.4°C (APO) vs 11 ± 3°C (APP), P = ns) in a similar time (11.9 ± 3.8 min (APO) vs 9.3 ± 3.4 mins (APP), P = ns). There was no graft primary non-function or graft arterial injury in either group. There was no significant difference between the APO and APP initial graft outcomes. The 3-month patient survival rate was identical in the two groups (95%); 81% of renal grafts from the APO donors functioned well from the time of transplantation as did 76% of those from APP donors.

Conclusions:

It is concluded that the APO procurement technique produces equivalent results to those achieved with the APP method. The simplicity of the APO technique makes it the preferred technique.

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