HEPATIC BLOOD-FLOW DURING REDUCED LIVER GRAFTING IN PIGS - A COMPARISON OF CONTROLS AND RECIPIENTS OF INTACT ALLOGRAFTS

Intraoperative changes in portal venous and hepatic arterial flow were compared in porcine recipients of reduced liver grafts with recipient s of intact grafts and sham-operated controls, Control animals showed no significant changes in hepatic blood flow (measured with perivascul ar ultrasonic cuffs), heart rate, mean arterial pressure, cardiac outp ut, acid/base balance, plasma sodium, potassium, glucose, or catechola mines. Recipients of intact or reduced grafts showed hypotension, redu ced cardiac output, tachycardia, and increased systemic vascular resis tance during the anhepatic phase, which lasted approximately 30 min. T hese changes returned to normal in recipients of intact grafts but in recipients of reduced grafts, levels returned only to 50-60% of baseli ne, After intact grafting, total liver blood flow and the portal and a rterial components returned to baseline within 2 hr of revascularizati on, but after reduced grafting, hepatic arterial flow values remained depressed to 50-60% of baseline. Plasma epinephrine and norepinephrine were unaltered during control operation but increased 4- to 20-fold i n recipients of all grafts, These returned towards baseline in all exc ept recipients of reduced grafts, in which norepinephrine levels remai ned significantly elevated for the 4 hr of postoperative study, These data highlight persistent elevation of plasma norepinephrine after red uced liver grafting, which may have contributed to the diminished hepa tic arterial flow. These results need to be confirmed in adult recipie nts of split liver grafts in whom grafts are comparatively small, In s uch patients receiving donor livers which have undergone prolonged sto rage, the effects of increased plasma norepinephrine levels upon donor agonal arterial spasm may be significant.