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A Modified Technique for Orthotopic Liver Transplantation

A. G. Ross Sheil, MS, FRCS, FRACS; J. Peter Halliday, FRCS, FRACS; J. Malcolm Drummond, FRCS, FRACS; Michael J. Bookallil, FFARCS, FFARACS; Paul L. Gaudry, FFARACS; Sol D. Yezerski
Arch Surg. 1972;104(5):720-724. doi:10.1001/archsurg.1972.04180050094024.
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A technique for orthotopic liver transplantation was used in 13 pigs, with 9 survivors. It incorporated rapid hepatic cooling at the time of donor death, continuous perfusion of the liver during hepatectomy and transplantation, rewarming of the allograft with oxygenated solution before revascularization with arterial blood shunted to the portal vein, early reestablishment of inferior vena caval flow and completion, and securing and release of each of the vascular anastomoses in turn. By these maneuvers the allograft was maintained cold and oxygenated for the entire ischemic interval, the anhepatic interval for the recipient and ischemic interval for the allograft were reduced, hypotension at the time of revascularization was prevented, and the threat of serious blood loss when multiple anastomoses are released simulatneously was eliminated.


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