Normothermal extracorporeal perfusion of the liver

: In view of providing hepatic assistance, and for conservation aims in attempts at transplantation conditions have been investigated for achieving extracorporeal normothermal perfusion of the liver isolated from pig and dog. A total of 33 experiments have been performed. The preparations and the devices used allow to apply the method in a patient only after stabilisation of the perfusion, and frees the medical team from a series of technical problems. The duration and the quality of the perfusion are especially influenced by the collecting technique. In the dog the liver should be removed 3--5 hours, and in the pig 7--8 hours before perfusion is started. The functional condition of the liver can be assessed at 45 minutes after the start of the perfusion by evaluating the following criteria: the macroscopic aspect of the liver, the blood flow, the biliary flow, the ascitis fluid, TGP and oxygen consumption. Adequate installations and a permanent involvement of the laboratory team are essential conditions for the application of this method to the treatment of acute severe hepatic failure.