INTRAOPERATIVE MEASUREMENT OF THE GRAFT OXYGENATION STATE IN LIVING-RELATED LIVER-TRANSPLANTATION BY NEAR-INFRARED SPECTROSCOPY

Graft oxygenation plays an important role in successful liver transpla ntation. Intraoperative changes in the oxygenation state of the liver graft were measured by near infrared spectroscopy in 28 cases of livin g related liver transplantation. Oxygen saturation of hemoglobin in th e liver (hepatic SO2) changed from 81.2 % +/- 1.5 % (mean +/- SEM) bef ore donation (in the donor) to 49.7 % +/- 4.2 % after portal reflow, t o 58.4 % +/- 5.0 % after arterial reflow, and then to 71.4 % +/- 3.9 % before closure. Mean hepatic SO2 was positively correlated with porta l flow rate as measured by duplex Doppler sonography. Cases with low p ortal flow rate showed a high coefficient of variation (SD/mean) of he patic SO2, indicating heterogeneous tissue oxygenation. Though graft s ize was expected to affect the graft oxygenation state, hepatic SO2 wa s fairly independent of the graft-to-recipient weight ratio. In two ca ses with markedly low hepatic SO2, postoperative graft dysfunction occ urred. This study suggest that the method of near infrared spectroscop y is reliable and useful for assessing the graft oxygenation state in liver transplantation.