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간장 ( 肝臟 ) , 담도 ( 膽道 ) 및 췌장 ( 膵臟 ) : 개의 동소성 간 이식에서 나타난 이식 간의 허혈성 손상 양상
이혁상(Hyuck Sang Lee),왕희정(Hee Jung Wang),백계형(Kye Hyeong Paik),전재홍(Jae Hong Jeun),서연림(Yeon Lim Suh),강신광(Shin Kwang Kang),우성(Sung Woo) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3
N/A The results of biopsy findings of livers in orthotopic liver transplantation of 24 dogs are as follows: 1) Ischemic injury sustained during the pre-reperfusion period is considered to manifest itself in association with reperfusion. 2) The predominant finding in harvesting injury of dogs is congestion, uncommon finding in humans. 3) Severe changes began to appear with the cold ischemic time of 205 min. or longer. 4) Hemosiderin deposits, not seen in humans, are found in 87.5% of organs with the cold ischemic time of over 295 min. 5) PMN-infiltrations in the necrotic area, seem to be the result of ischemic injury rather than the manipulation injury.
백계형,이혁상 인제대학교 1991 仁濟醫學 Vol.12 No.1
저자들은 개의 동소성 간이식을 hepatic vascular exclusion 상태에서 piggyback 술식으로 시행하여 좋은 결과를 얻었기에 보고하는 바이다. We report here a modification of the standard orthotopic liver transplantation procedure in dogs whereby the full length of the recipient IVC Is preserved. The new fiver is placed "piggyback" onto the anterior surface of the vena casa. Particularly apealing features of this procedure in dogs are as follows; 1) Hemostatic maneuver after grafting of new liver is rendered much easler 2) Omission of infrahepatic vela caval anastomosis shotrens operative time and calls for lesser degree of manipulation of new liver. 3) Size disparities between the small donor and large recipient vessels ran be better adjusted. 4) Physiologic disturbance can be minimized even when bypass becomes inadequate during the procedure.
왕희정,우성,이혁상,백낙환,백계형,김칠규 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6
We performed living-related liver transplantation in 9 dogs to assess the technical feasibility of the procedure from February 1991 through January 1992. Conclusions derived from the experiment were as follows: 1) The main cause of liver congestion leading to hemorrhage at the resected surface of the grafts after reperfusion seems to be due to the angulation at the anastomotic site of the left hepatic vein rather than the outflow block proposed by Broelsch. 2) In harvesting the left central and left lateral segments, the quadrate and caudate iobes should be removed to avoid leaving these vascularly compromised lobes.
Centrifugal Pump 를 이용한 개의 간이식술 10 례
조강희,우성,송찬우,왕병진,이혁상,백계형 대한마취과학회 1990 Korean Journal of Anesthesiology Vol.23 No.6
he Orthotopic liver transplantation for the terminal liver diseases has been performed frequently since the introduction of new immuno-suppressive agent (cyclosporin A), technical advances in surgical skill, uae of biopump during anhephatic stage, rapid infusion system for transfusion and thromboelastography for coagulopathies were used. In Korea, only one case of orthotopic liver transplantation succeeded in 1988, but the animal experiments have been going on for many years in many institutes. Orthotopic liver transplantation in dogs using centrifugal pump (Bio-pump) were experienced and the results were analysed; 1) There were no differences in hemodynamic parameters during anhepatic stage with assistance of Biopump compared with preanhephatic stage. 2) The mean flow rate of Biopump during anhepatic stage was 0.75±0.09L/min, and maximun and minimum flow rate were 1.5L/min. and 0.4L/min, respectively. 3) Mean artery pressure, cardiac output and systemic vascular resistance after reperfusion of transplanted iver were significantly reduced compared with the values of before reperfusion; meanwhile, mean pulmonary artery pressure, pulmonary capillary wedge pressure and pulmonary vascular resistance were not significantly different. 4) After reperfusion of transplanted liver serum potassium level was significantly increased to 6. 07±1.8 mEq/L and the amount of base was significantly decrease to -12.9±5.9 mEq/L. By using Bio-pump the degree of hemodynamic changes could be reduced during the clamping of inferior vena cava and hepatic vein.