THE DIFFERENCE BETWEEN THE CHANGES IN SYSTEMIC OXYGEN-CONSUMPTION DURING ORTHOTOPIC LIVER-TRANSPLANTATION AND THOSE DURING EXTRACORPOREAL HEPATIC RESECTION

Every organ in the body requires oxygen to perform its function. In li ver transplantation and extracorporeal hepatic resection, oxygen utili zation by the graft or the re-implanted liver is a prerequisite for re storation of liver function. We compared the changes in systemic oxyge n consumption in a patient who underwent orthotopic liver transplantat ion with those in two patients who underwent extracorporeal hepatic re section. The pre-anhepatic systemic oxygen consumption in the patient who underwent orthotopic liver transplantation seemed to be lower than that in the patients who underwent extracorporeal hepatic resection, possibly due to the depressed oxygen utilization which sometimes occur s in cirrhotic patients. The increase in oxygen consumption or the ove rconsumption of oxygen after reperfusion was more significant in the p atient who underwent orthotopic liver transplantation than in the pati ents who underwent extracorporeal hepatic resection. The possible caus es might be the greater hepatic oxygen debt, an associated intestinal oxygen debt, and/or the greater ischemia/reperfusion-induced overprodu ction of superoxide anion in the patient who underwent orthotopic live r transplantation. The differences between the changes in systemic oxy gen consumption during orthotopic liver transplantation and those duri ng extracorporeal hepatic resection further support the usefulness of systemic oxygen consumption to predict the immediate restoration of bl ood flow and oxygen utilization in the graft or the re-implanted liver . These findings also support the importance of evaluating oxygen cons umption to confirm whether the critically ill or unconscious patient c an utilize oxygen on demand or not.