EFFICACY OF HYPOTHERMIC PERFUSION USING UNIVERSITY-OF-WISCONSIN SOLUTION IN EXTENDED HEPATECTOMY WITH HEPATIC INFLOW OCCLUSION IN A CANINE MODEL

This study was designed to elucidate the efficacy of University of Wis consin (UW) solution for preventing liver injury, when used as a hypot hermic perfusate infused into the systemic circulation during extended hepatectomy with hepatic inflow occlusion. Adult mongrel dogs (9.5-17 .5 kg, n = 14) were subjected to 75% hepatectomy under 60 min hepatic inflow occlusion. The animals were divided into two groups. The UW gro up (n = 7) underwent hypothermic perfusion using 4 degrees C UW soluti on (core temperature of the liver: 12.3 +/- 0.2 degrees C). The contro l group designated as the Ringer's lactate (LR) group (n = 7) underwen t hypothermic perfusion using 4 degrees C LR solution. The perfusate w as introduced into the systemic circulation via the hepatic vein. Bloo d from the hepatic vein was sampled, and alanine aminotransferase, pur ine nucleoside phosphorylase activities and the ammonia concentration were measured. The 7 day survival rate was higher in the UW group than in the LR group. The parameters of liver function were less significa ntly altered in the UW group than in the LR group. The plasma ammonia concentration was significantly (P < 0.05) lower 6h after reperfusion in the UW group than in the LR group. A small volume of hypothermic pe rfusion of the liver using UW solution was safe if it returned to syst emic circulation. Hypothermic perfusion of the liver using UW solution may be effective for preventing hepatic tissue injury during extended hepatectomy with hepatic vascular occlusion.