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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.
백계형 인제대학교 1990 仁濟醫學 Vol.11 No.3
개의 동소성 간 이식에서 재관류 후에 나타나는 혈역학적 변화는, 종래의 보고들과는 달리, 사람에서와 동일한 PRS(post reperfusion syndrome) 양상으로 나타났다. We studied the cardiovascular changes occuring after reperfusion of the donor liver during orthotopic liver transplantation (OLT) in ten mongel dogs. On declamping the portal vein and infector vena casa after anastomosis of the new limier, there was a decrease in MAF, SVR, PR, CO and body temperature, and an increase in MPAP, PAWP and CVP in most cases. Of significance was the uniform decrease of MAP to the average of 51.8% of baseline value. In no case was the hepatic congestion evident. These results led us to the conclusion that the hypotension after reperfusion of ischemic liver is dog is a PRS doe to systemic vasodilatation rater than the dog-specific syndrome like outflow block syndrome or blue liver syndrome. The PRS in dogs are more pronounced in degree and higher in incidence compared to the one seen in humans. The syndrome was easily controlled by cocomitent administration of epinephrine along with appropriate volute replacement.