THE DIFFERENCE BETWEEN THE CHANGES IN SYSTEMIC OXYGEN-CONSUMPTION DURING ORTHOTOPIC LIVER-TRANSPLANTATION AND THOSE DURING EXTRACORPOREAL HEPATIC RESECTION
K. Irita et al., THE DIFFERENCE BETWEEN THE CHANGES IN SYSTEMIC OXYGEN-CONSUMPTION DURING ORTHOTOPIC LIVER-TRANSPLANTATION AND THOSE DURING EXTRACORPOREAL HEPATIC RESECTION, Tohoku Journal of Experimental Medicine, 180(3), 1996, pp. 217-223
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.