Document Detail


Non-invasive measurement of hepatic oxygenation by an oxygen electrode in human orthotopic liver transplantation.
MedLine Citation:
PMID:  11121770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Precise evaluation of graft reperfusion is difficult in clinical liver transplantation. The oxygen electrode (OE) is a novel technique to detect blood flow indirectly by measuring the quantity of oxygen which can diffuse from the hepatic tissue to the surface electrode. Application of the surface OE does not influence the liver blood flow or parenchymal perfusion. Adequate graft oxygenation is essential to the outcome of organ transplantation and has not previously been analysed intra-operatively in liver transplant recipients. The OE was applied to the surface of the graft intra-operatively in 22 human liver grafts after restoring portal vein and hepatic artery inflow. OE readings were compared with liver blood flow using an electromagnetic flowmeter (EMF). Intra-operative haemodynamics and donor organ parameters known to influence graft function were correlated with the OE readings. There was a significant correlation (r=0.89; p<0.001, n=14) between tissue oxygenation using the OE and total liver blood flow measured by EMF. The tissue oxygenation measurements were reproducible with a coefficient of variation of 5%. The hepatic tissue oxygenation increased significantly from baseline following venous reperfusion of the graft (282+/-23 vs 3107+/-288 (+/-SE) nA, p<0.001). Hepatic arterial revascularisation resulted in a significant (p<0.001) increase of 41+/-7% in liver oxygen perfusion. There was significant negative correlation (r=0.80, p<0.001, n=22) between cold ischaemic time and graft tissue oxygenation. The OE provides a reliable, cheap and non-invasive method of monitoring liver graft oxygenation and perfusion during transplantation.
Authors:
A M Seifalian; S Mallett; C Piasecki; K Rolles; B R Davidson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medical engineering & physics     Volume:  22     ISSN:  1350-4533     ISO Abbreviation:  Med Eng Phys     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2001-01-02     Completed Date:  2001-01-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9422753     Medline TA:  Med Eng Phys     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  371-7     Citation Subset:  IM    
Affiliation:
University Department of Surgery and Liver Transplantation, Royal Free and University College Medical School, University College London and The Royal Free Hospital, Pond Street, London NW3 2QG, UK. a.seifalian@rfc.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Electrodes*
Female
Humans
Liver / metabolism*
Liver Circulation
Liver Transplantation*
Male
Monitoring, Intraoperative / instrumentation*
Oxygen / metabolism*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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