Feasibility of a New Technique of Reperfusion in Liver Transplantation

Background: Poor initial graft function secondary to reperfusion remains a major problem in liver transplantation. Retrograde reperfusion, a new method of reperfusion during liver transplantation was introduced in our center. We evaluated this technique in a retrospective study and compared the results concerning primary graft function with a historical control group. Methods: In the study group 56 liver transplantations were performed in piggy-back technique with retrograde reperfusion. In the historical control group 21 patients underwent liver transplantation in standard technique with standard reperfusion. Results: Fifty (twenty) out of 53 (21) patients were alive and well on day 8 after liver transplantation. On day 1 after liver transplantation, mean aspartate aminotransferase was 221 U/L in the study group and except of 3 patients (6,6%) with hepatic artery thrombosis no primary nonfunction appeared. In the control group on day 1 after liver transplantation mean aspartate aminotransferase was 327 U/L and three patients (14,2%) had primary nonfunction. Conclusions: Our retrospective study demonstrates that retrograde reperfusion via the caval vein and antegrade reperfusion via the portal vein is feasible; it lowered postoperative liver enzyme values and improved initial liver function after LTX. Further careful evaluation will be necessary to verify these findings.