Hemodynamic and metabolic variables predict porcine ex vivo liver function

Early recognition of hepatic function during initial graft reperfusion is i mportant in beginning hepatic support perfusions as well as in liver transp lantation. We hypothesized that both hemodynamic and metabolic perfusion va riables obtained immediately after reperfusion predict eventual function du ring liver support or transplantation. Specific hemodynamic variables, i.e. , portal vein pressure and hepatic vascular resistance, as well as metaboli c variables, i.e., O-2 consumption and P-CO2 gradients, were compared with indices of hepatic function and damage, i.e., aqueous bile production, bile lipid outputs, lactate dehydrogenase levels, and histopathology, during an ex vivo support perfusion. O-2 consumption during early reperfusion correl ated directly with unstimulated bile flows (P < 0.02) and histopathology sc ores (P < 0.05). Hepatic venous P-CO2 gradients correlated inversely with u nstimulated bile hows (P < 0.05). Hemodynamic variables, i.e., portal vein pressure and hepatic vascular resistance, were inversely related with tauro cholate-stimulated bile flows (P < 0.05). Hemodynamic and metabolic variabl es of early reperfusion are useful parameters in predicting eventual effect iveness of the harvested liver for ex vivo hepatic support perfusions. (C) 2001 Academic Press.