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Immediate and Long-Term Effects of Acute Hepatic Ischemia

Orvar Swenson, MD; Luis Grana, MD; Tohru Inouye, PhD; William L. Donnellan, MD
Arch Surg. 1967;95(3):451-463. doi:10.1001/archsurg.1967.01330150127017.
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FOR the past decade there has been an increasing interest in liver transplantation. To determine its clinical acceptability, the period of ischemia the liver can tolerate with subsequent adequate function should be established. There have been a number of investigations designed to determined immediate liver function following vascular occlusion. In 1925, Duchinova found that death occurred when ligation of both inflow vessels exceeded 35 minutes.1 Raffucci's experiments in 1953 indicated that 20 minutes was the maximal period of tolerance to occlusion of the hepatic efferent vessels.2 De Weese and Lewis observed that partial interruption of portal vein flow and temporary ligation of the hepatic artery of one hour's duration was tolerated by some dogs.3 In biochemical investigations Sicular and Moore have used glucose labeled with carbon 14 (14C) to demonstrate the acute effects of anoxia on hepatic glucose metabolism.4 Other authors have studied the metabolism


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