The effect of exclusion of the white blood cell on the artificial liver support by an extracorporeal heterologous liver perfusion.

1994 Fiscal Year Final Research Report Summary

• Project/Area Number: 05671087
• Research Category: Grant-in-Aid for General Scientific Research (C)
• Allocation Type: Single-year Grants
• Research Field: Digestive surgery
• Research Institution: TEIKYO UNIVERSITY
• Principal Investigator: KIMURA Kenichi Teikyo University・Medicine Assistant Professor, 医学部, 講師 (00135576)
• Project Period (FY): 1993 – 1994
• Keywords: Artificial Liver Support / Extracorporeal Liver Perfusion / White Blood Cell

Research Abstract

A male albino rabbit was performed laparotomy under anesthsia with pentobarbital sodium, 300 ml of cold (4C) University of Wisconsin solution was administered through a catheter placed in the portal vein and the liver was removed for extracorporealperfusion. Human blood was donated by a healthy male volunteer. WBC filter (Sepacell ; Asahi nedical Co., LTD) was used. The perfusate was arranged to 15-20% of hematocritt and pH7.3 - 7.4 with lactated Ringer's solusion and sodium bicarbonate. As an anticoagulant agent, heparin or CPD was used. The liver perfusion was performed with 200ml of perfusate, administered into the portal vein with the rate of 0.5-1ml/g. liver/min.for 6 hours. When the rate became less than 0.3ml/g.liver/min., the portal pressure became more than 30cmH_2O or the loss of perfusate increased to be unable to continue the perfusion, the perfusion was stopped. When heparinized rabbit blood was used as the perfusate, the perfusion was main-tained in good condition for 6 h ours with the portal pressure less than 20cm H_2O.The energy charge of the liver tissue was 0.833 1 hour after beginning of the perfusion and 0.781 6 hours afterwards. The ketone body ratio of the perfusate was 0.64 1 hour after the beginning of the perfusion and 0.54 6 hours afterwards. The use of WBC filter or cyclosporin made no remarkable change on the perfusion. When haparinized human blood was used as perfusate, the perfusion went uneventful with WBC filter. The average hours of perfusion was 5.8, the portal pressure was less than 30cmH_2O throughout the perfusion, The energy charge was 0.807 1 hour after the begnning and 0.762 at the end. In one of the3 cases without WBC filter, the perfusion had to be stopped within 1 hour after the begnning because of the elevated portal pressure. The other 2 cases showed no significant difference from those with WBC filter. The use of CPD resulted a great loss of the perfu-sate in every perfusion with rabbit or human blood and the perfusion was ceased within 1-4 hours.