METHOD FOR ISOLATED SHARED PORTO-CAVAL LIVER PERFUSION IN EXPERIMENT Russian patent published in 2021 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to surgery, oncology, transplantology. Cadaveric liver explantation is carried out, the perfused lobe is determined. Next, the portal vein is mobilized and the short veins of the liver are also ligated; after that, a venous cannula with an external diameter of 6 to 12 mm is installed into the branch of the portal vein of the perfused lobe, with additional fixation with a vascular turnstile to prevent the perfusate from being thrown into the contralateral branch of the portal vein. Next, a cannula with an external diameter of 14 to 35 mm is inserted into the retrohepatic segment of the inferior vena cava. After that, a perfusion circuit is formed by connecting the inflow systems from the reservoir with perfusate to the liver - to the cannula in the portal vein branch, outflow from the liver to the reservoir - to the cannula in the retrohepatic segment of the inferior vena cava. The circuit also includes reservoirs with a solution for perfusion and for collecting it at the outlet of the circuit, a pump for perfusion, a thermostatic bath and connectors for connecting infusion filters, branch pipes, extension cords, tee-connectors for infusion systems. Then, to determine the interlobar border of the liver, a solution of a water-soluble dye in a volume of 20 to 150 ml is injected bolus into the venous cannula. Further, the identified inter-lobe boundary is marked with X-ray-positive objects. After that, isolated lobar portocaval liver perfusion is performed in the following mode: flow rate - 110-650 ml/min, duration - 20-60 min, perfusate temperature - 37-43°C. Then, during perfusion, comparative thermometry of the perfused and contralateral lobes of the liver is performed to assess the dynamics of temperature rise. During perfusion, in order to control the spread of perfusate in the parenchyma, a water-soluble X-ray contrast solution is injected with a total volume of up to 100-150 ml / min and fluoroscopy is performed; then, at the end of the perfusion, cholecystectomy is performed; after which the liver preparation is examined and disposed of.

EFFECT: method ensures performing sequentially operational techniques allowing isolating lobar portal blood flow of the liver and carrying out its selective perfusion, as well as delivering of various pharmaceuticals with the exclusion of their leakage into the contralateral lobe of the liver.

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