Abstract:

Objective To summarize the experience of split-orthotopic liver transplantation model in swineswithout veno-venous bypass. Methods A total number of 40 Bama mini-swines were used in this study, whichwere randomly divided into donor group and recipient group, with 20 swines in each group. 20 cases of split-orthotopicliver transplantation without veno-venous bypass were performed under general anesthesia. Arterial blood gas analysis and hemodynamic parameters were measured. The influence of the management during operations was also discussed. Results Eighteen of the recipients were successfully extubated and awake 1-2 hours postoperations. Allswines can eat and drink normally on the second post-operative day. Three of them died on the third post-operative day because of abdominal infection. The survival rate of 5 days past operation was 65%. Compared with pre-anhepaticphase，the mean arterial pressure and central venous pressure were significantly decreased and the heart rate wassignificantly increase in anhepatic phase〔mean arterial pressure（mmHg）：58.5±8.2 vs. 105.3±10.0，central venous pressure（cmH2O）：2.17±2.11 vs. 5.51±4.06，heart rate（times/min）：151.3±16.0 vs. 121.9±8.8，allP ＜ 0.05〕. Compared with anhepatic phase，pH value was significantly decreased，K+ and the concentration of lacticacid were significantly increased in hepato-repepusion〔pH ：7.307±0.083 vs. 7.514±0.071，K+ concentration （mmol/L）：5.86±0.71 vs. 3.36±0.28，lactic acid（mmol/L）：6.53±1.54 vs. 3.39±1.03，all P ＜ 0.05〕. Conclusion Hemodynamic and arterial blood gas analysis changes significantly during split-orthotopic livertransplantation in swines. By using moderate vasoactive substances, to maintain the hemodynamic parameters stability in the anhepatic phase and the short anhepatic phase are important to perform successful split-orthotopic livertransplantation.