Abstract: Introduction: Insitu hypothermic perfusion (HP) can be applied to attenuate ischemia and reperfusion (I/R) injury during liver resection under total vascular exclusion (TVE). This study examines the protective effect of cooling by HP at 20 and 28°C as compared with no HP during TVE in a porcine liver I/R model.
Methods: Twenty-one pigs underwent 60 min TVE of the liver followed by 24 h reperfusion. HP was performed via the portal vein using ringerlactate solution of 4°C. Pigs were assigned to three groups: TVE without HP (no-HP, n=9), TVE with HP at 28°C (HP-28, n=6) and TVE with HP at 20°C (HP-20, n=6).
Results: Perfusion volumes during TVE were 5.1±0.5 and 17.3±1.7 l in HP-28 and HP-20, respectively (P<0.05). Aspartate aminotransferase (AST) after 24 h reperfusion was 1172±440 U/l in no-HP as compared with 223±69 and 180±22 U/l in HP-28 and HP-20, respectively (P<0.05). No differences in liver function or histopathology were found between the HP-28 and HP-20 groups.
Conclusions: HP at 20°C is equally effective in preserving liver function and preventing hepatocellular injury under TVE as compared with HP at 28°C. HP at 28°C is advised, because of the lesser perfusion volume necessary for cooling of the liver.