A percutaneous technique for venovenous bypass in orthotopic cadaver liver transplantation and comparison with the open technique

✍ Scribed by Johnson, Scott R. ;Marterre, William F. ;Alonso, Maria H. ;Hanto, Douglas W.

• Publisher: Wiley (John Wiley & Sons)
• Year: 1996
• Tongue: English
• Weight: 651 KB
• Volume: 2
• Category: Article
• ISSN: 1074-3022
• DOI: 10.1002/lt.500020505

✦ Synopsis

Venovenous bypass minimizes the hemodynamic alterations during the anhepatic phase of liver transplantation. A new technique for the percutaneous placement of the bypass cannulae is described and compared to the cut-down ("open") technique. The records of 81 patients who underwent 94 liver transplants between August 1991 and April 1994 were reviewed for indications for transplant, United Network for Organ Sharing status, mean age, body surface area, bypass technique and time, flow rates, cardiac output, mean arterial pressure and central venous pressure during bypass, the development of deep venous thrombophlebitis, and lymphoceles. Femoral flow rates were higher in the open group (2054 2 74 mL/min), compared with the percutaneous group (1726 r+-74 mL/min) (p = 0.003). Total flow rates in the open (2238 f 58 mL/min) and percutaneous (2197 & 67 mL/min) groups were not different. Maximum cardiac outputs (L/ min) were higher in the open (10.1 f 0.6) versus percutaneous group (7.0 2 0.5) (p < 0.0002). Similarly, minimum cardiac outputs (L/min) were higher in the open (8.9 & 0.7) versus percutaneenovenous bypass in liver transplant recipients V has typically been performed by the placement of heparin-bonded cannulae into the axillary and femoral veins using cut-downs. 1,2 Complications of femoral and axillary cut-downs include wound infections, hematomas, and lymphoceles.1,3-6 A detailed analysis of the complications related to the placement of venous cannulae through cut-downs has not been previously described. Recently, the percutaneous placement of the femoral cannulae with an axillary vein cut-down' and the percutaneous place-From the