Double-balloon catheter for isolated liver perfusion: An experimental study

Purpose: Further development of a previously described interventional metho d for isolated liver perfusion (ILP) with a new double-lumen balloon cathet er, and evaluation of the side-effects of such isolation. Method: In six pigs a double-balloon occlusion catheter was placed via the transjugular approach with its tip in the portal vein. One of the balloons was positioned in the inferior vena cava (IVC), cranial to the origin of th e hepatic veins and the other balloon in the portal vein. By the transfemor al approach, a single-balloon occlusion catheter was placed in the IVC caud al to the origin of the hepatic veins. A third catheter was placed by the t ransfemoral route with the occlusion balloon in the proper hepatic artery. After inflation of all balloons Tc-99(m)-labelled human serum albumin was r ecirculated through the liver. The isolation was evaluated by repeated meas urement of radioactivity levels in peripheral blood. Laboratory tests of li ver and pancreas function, and hemoglobin, were taken before, at the end of , and 3 days after the procedure. Blood gases were tested at the beginning and end of the procedure. Results: One pig died during the procedure due to technical failure and was excluded from the study. In the other pigs leakage from the isolated liver to the systemic circulation increased slowly, up to 9.7% (mean) during 30 min of recirculation of the perfusate through the liver. Laboratory tests w ere normal in all pigs except insignificant acidosis directly after the pro cedure and the slight elevation of s-ALAT after 3 days. Conclusions: Only minor leakage from the liver to the systemic circulation was noted during ILP performed with a new, double-balloon catheter. There w ere no serious side effects.