METHOD OF ISOLATED LOBAR ARTERIO-CAVAL PERFUSION OF LIVER IN EXPERIMENT Russian patent published in 2020 - IPC G09B23/28 A61B17/00 A61M1/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, oncology and transplantology. After explantation of cadaver liver perfusable fraction for perfusion is determined with required preparation and conditionally perfusible contralateral portion - a fraction for creation of hydrodynamic conditions corresponding to physiological ones. Further, a ligamentous hepatic ligature is ligated, a portal vein (PV) of the explosive, its branches, a proper hepatic artery - PHA, a right - RA and a left LA - branch are mobilized, and a retro-hepatic segment RHS - an inferior vena cava - IVC is mobilized. Then, using a monopolar electric coagulator, a gallbladder is removed; then, cannulas with an external diameter of 2 to 3 mm in RA and LA are successively installed. Thereafter, a vascular turnstile is applied on the explosives to rule out the retrograde leak of the perfusate. Further, cannula of 25 to 35 mm is inserted into the RHS IVC; its distal and proximal ends are sealed. Thereafter, an open perfusion loop is formed by attaching inflow systems from a reservoir with a perfusate to a liver preparation, attaching an effluent system from the preparation to a reservoir - to a cannula in the RHS IVC, composition of the circuit also includes reservoirs with a solution for perfusion and for its collection at the outlet of the contour, two peristaltic pumps for inflow separately to the RA and LA, a thermostatic bath and connectors for connection of infusion filters, splitters, extensions, tees for infusion systems. Solutions of the water-soluble dye in the volume of up to 80–100 ml are introduced into the arterial cannula to determine the interlobar border of the liver. Further, the detected intersectional boundary is marked with X-ray positive objects. That is followed by separate perfusion of liver lobes: for the perfusion fraction in the following regimen: flow rate - 110–350 ml/min, duration - 20 min, perfusate temperature - 41–43 °C. For the conventionally perfused contralateral lobe in the mode: flow rate - 110–350 ml/min, duration - 20 min, temperature of perfusate - 20–30 °C. Perfusate flow rate in the perfusated fraction should not exceed that in the conditionally perfusible fraction. Further, during perfusion, a water-soluble X-ray contrast solution with total volume of up to 100–150 ml is administered. That is followed by X-ray examination using an X-ray diagnostic apparatus.

EFFECT: method enables performing sequential surgical procedures that enable to isolate the arterial blood flow of the liver and perform its selective perfusion with the required preparation, method enables improving previous methods and developing new methods for combined treatment of multiple bilobar liver injuries, as well as creating a basis for using transplantation technologies in abdominal ex vivo surgery.

1 cl, 2 ex, 5 dwg