外科ジャーナル

New Vascular Ligation Technique Applied in Liver Transplantation

Abstract

Radu Zamfir, Vladislav Bra�?�?�?�?�oveanu, Leonard David, Cristian Lupa�?�?�?�?�cu, Florin Cristian Bl�?�??�?�?ju�?�?�?�?�, Tudor Stoian, Luiza �?�?�?širc�?�??�?�? and Irinel Popescu

Liver procurement is a race against time, which is mainly focused on obtaining a good quality of liver grafts with an ischemia time as short as possible. The actual procurement time definitely influence cold ischemia time, a reduction of it leading to shorter graft cold ischemia time.

Methods: We examined the use of tire-ups in the liver procurement, in terms of improving the procurement time (calculated as the time between incision and the time of starting infusing portal vein and aorta with cold preservation solutions).

Results: We enrolled in our study two groups of 30 donors each. In the first group we included patients on which we did not use the tire-ups, and in the second patients on which the tire-ups were used for dissection and rapid clamping of the infrarenal aorta and the portal vein. Procurement time in group 1 averaged 121.6 minutes (+/- 20.2 minutes) and in the second batch averaged 88 minutes (+/- 16.2 minutes), with statistical significance (p<0.05). We observe a reduction of about 30 minutes between batches, reduction which was possible using tire-ups in rapid dissection and clamping of the portal vein and aorta.

Conclusions: The use of tire-ups are a simple, cheap and feasible to shorten operative time in liver procurement. It can be successfully applied to all donors shortening the actual time of sampling, with direct consequences to cold ischemia time.