Extracorporeal support with a cadaver liver as a bridge to transplantation

L. W. Fristoe, J. H. Merrill, J. A. Kangas, J. E. Vogel, A. H. Stammers, Alan Norman Langnas, I. J. Fox, B. W. Shaw

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Extracorporeal liver perfusion (ECLP) has been used for detoxifying blood in patients in class IV hepatic encephalopathy. Palliation of the moribund patient utilizing extracorporeal devices with cross-circulation of a cadaver liver has been documented for over three decades. Common problems associated with this procedure which appear in the literature include cadaver liver distention, increased resistance to blood flow, and limited time of extracorporeal support due to cadaver liver failure. This report summarizes the experiences of the perfusion team in utilizing an extracorporeal circuit with an otherwise nontransplantable cadaveric liver, to support the decompensating hepatic patient as a bridge to transplantation. Between January and July 1992, three patients were supported for hepatic failure with ECLP. Two patients were placed on ECLP with a modified circuit containing two positive displacement pumps and one centrifugal pump. The third patient was placed on ECLP with a circuit that contained two centrifugal pumps and one positive displacement pump. Patient age ranged from 6 to 38 years and length of support ranged from 24 to 72 hours. In all three patients, a centrifugal pump was placed in the suprahepatic inferior vena cava line to facilitate cadaver liver drainage and decompression. Intensive monitoring of both patient and cadaver liver hemodynamics, hepatic function, and hematological status was performed. All three patients were successfully weaned from ECLP. Two patients received successful orthotopic liver transplantation. The third died of complications unrelated to ECLP after support was discontinued. At present, the technique of ECLP has been shown to be an effective treatment for supporting the comatose patient with fulminant hepatic failure prior to transplantation.

Original languageEnglish (US)
Pages (from-to)133-139
Number of pages7
JournalJournal of Extra-Corporeal Technology
Volume25
Issue number4
StatePublished - Dec 1 1993

Fingerprint

Cadaver
Transplantation
Liver
Perfusion
Liver Failure
Cross Circulation
Hepatic Encephalopathy
Acute Liver Failure
Inferior Vena Cava
Physiologic Monitoring
Coma
Decompression
Liver Transplantation
Drainage
Hemodynamics

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Fristoe, L. W., Merrill, J. H., Kangas, J. A., Vogel, J. E., Stammers, A. H., Langnas, A. N., ... Shaw, B. W. (1993). Extracorporeal support with a cadaver liver as a bridge to transplantation. Journal of Extra-Corporeal Technology, 25(4), 133-139.

Extracorporeal support with a cadaver liver as a bridge to transplantation. / Fristoe, L. W.; Merrill, J. H.; Kangas, J. A.; Vogel, J. E.; Stammers, A. H.; Langnas, Alan Norman; Fox, I. J.; Shaw, B. W.

In: Journal of Extra-Corporeal Technology, Vol. 25, No. 4, 01.12.1993, p. 133-139.

Research output: Contribution to journalArticle

Fristoe, LW, Merrill, JH, Kangas, JA, Vogel, JE, Stammers, AH, Langnas, AN, Fox, IJ & Shaw, BW 1993, 'Extracorporeal support with a cadaver liver as a bridge to transplantation', Journal of Extra-Corporeal Technology, vol. 25, no. 4, pp. 133-139.
Fristoe LW, Merrill JH, Kangas JA, Vogel JE, Stammers AH, Langnas AN et al. Extracorporeal support with a cadaver liver as a bridge to transplantation. Journal of Extra-Corporeal Technology. 1993 Dec 1;25(4):133-139.
Fristoe, L. W. ; Merrill, J. H. ; Kangas, J. A. ; Vogel, J. E. ; Stammers, A. H. ; Langnas, Alan Norman ; Fox, I. J. ; Shaw, B. W. / Extracorporeal support with a cadaver liver as a bridge to transplantation. In: Journal of Extra-Corporeal Technology. 1993 ; Vol. 25, No. 4. pp. 133-139.
@article{3e3d46181d474232a82628b998d62095,
title = "Extracorporeal support with a cadaver liver as a bridge to transplantation",
abstract = "Extracorporeal liver perfusion (ECLP) has been used for detoxifying blood in patients in class IV hepatic encephalopathy. Palliation of the moribund patient utilizing extracorporeal devices with cross-circulation of a cadaver liver has been documented for over three decades. Common problems associated with this procedure which appear in the literature include cadaver liver distention, increased resistance to blood flow, and limited time of extracorporeal support due to cadaver liver failure. This report summarizes the experiences of the perfusion team in utilizing an extracorporeal circuit with an otherwise nontransplantable cadaveric liver, to support the decompensating hepatic patient as a bridge to transplantation. Between January and July 1992, three patients were supported for hepatic failure with ECLP. Two patients were placed on ECLP with a modified circuit containing two positive displacement pumps and one centrifugal pump. The third patient was placed on ECLP with a circuit that contained two centrifugal pumps and one positive displacement pump. Patient age ranged from 6 to 38 years and length of support ranged from 24 to 72 hours. In all three patients, a centrifugal pump was placed in the suprahepatic inferior vena cava line to facilitate cadaver liver drainage and decompression. Intensive monitoring of both patient and cadaver liver hemodynamics, hepatic function, and hematological status was performed. All three patients were successfully weaned from ECLP. Two patients received successful orthotopic liver transplantation. The third died of complications unrelated to ECLP after support was discontinued. At present, the technique of ECLP has been shown to be an effective treatment for supporting the comatose patient with fulminant hepatic failure prior to transplantation.",
author = "Fristoe, {L. W.} and Merrill, {J. H.} and Kangas, {J. A.} and Vogel, {J. E.} and Stammers, {A. H.} and Langnas, {Alan Norman} and Fox, {I. J.} and Shaw, {B. W.}",
year = "1993",
month = "12",
day = "1",
language = "English (US)",
volume = "25",
pages = "133--139",
journal = "Journal of Extra-Corporeal Technology",
issn = "0022-1058",
publisher = "American Society of Extra-Corporeal Technology",
number = "4",

}

TY - JOUR

T1 - Extracorporeal support with a cadaver liver as a bridge to transplantation

AU - Fristoe, L. W.

AU - Merrill, J. H.

AU - Kangas, J. A.

AU - Vogel, J. E.

AU - Stammers, A. H.

AU - Langnas, Alan Norman

AU - Fox, I. J.

AU - Shaw, B. W.

PY - 1993/12/1

Y1 - 1993/12/1

N2 - Extracorporeal liver perfusion (ECLP) has been used for detoxifying blood in patients in class IV hepatic encephalopathy. Palliation of the moribund patient utilizing extracorporeal devices with cross-circulation of a cadaver liver has been documented for over three decades. Common problems associated with this procedure which appear in the literature include cadaver liver distention, increased resistance to blood flow, and limited time of extracorporeal support due to cadaver liver failure. This report summarizes the experiences of the perfusion team in utilizing an extracorporeal circuit with an otherwise nontransplantable cadaveric liver, to support the decompensating hepatic patient as a bridge to transplantation. Between January and July 1992, three patients were supported for hepatic failure with ECLP. Two patients were placed on ECLP with a modified circuit containing two positive displacement pumps and one centrifugal pump. The third patient was placed on ECLP with a circuit that contained two centrifugal pumps and one positive displacement pump. Patient age ranged from 6 to 38 years and length of support ranged from 24 to 72 hours. In all three patients, a centrifugal pump was placed in the suprahepatic inferior vena cava line to facilitate cadaver liver drainage and decompression. Intensive monitoring of both patient and cadaver liver hemodynamics, hepatic function, and hematological status was performed. All three patients were successfully weaned from ECLP. Two patients received successful orthotopic liver transplantation. The third died of complications unrelated to ECLP after support was discontinued. At present, the technique of ECLP has been shown to be an effective treatment for supporting the comatose patient with fulminant hepatic failure prior to transplantation.

AB - Extracorporeal liver perfusion (ECLP) has been used for detoxifying blood in patients in class IV hepatic encephalopathy. Palliation of the moribund patient utilizing extracorporeal devices with cross-circulation of a cadaver liver has been documented for over three decades. Common problems associated with this procedure which appear in the literature include cadaver liver distention, increased resistance to blood flow, and limited time of extracorporeal support due to cadaver liver failure. This report summarizes the experiences of the perfusion team in utilizing an extracorporeal circuit with an otherwise nontransplantable cadaveric liver, to support the decompensating hepatic patient as a bridge to transplantation. Between January and July 1992, three patients were supported for hepatic failure with ECLP. Two patients were placed on ECLP with a modified circuit containing two positive displacement pumps and one centrifugal pump. The third patient was placed on ECLP with a circuit that contained two centrifugal pumps and one positive displacement pump. Patient age ranged from 6 to 38 years and length of support ranged from 24 to 72 hours. In all three patients, a centrifugal pump was placed in the suprahepatic inferior vena cava line to facilitate cadaver liver drainage and decompression. Intensive monitoring of both patient and cadaver liver hemodynamics, hepatic function, and hematological status was performed. All three patients were successfully weaned from ECLP. Two patients received successful orthotopic liver transplantation. The third died of complications unrelated to ECLP after support was discontinued. At present, the technique of ECLP has been shown to be an effective treatment for supporting the comatose patient with fulminant hepatic failure prior to transplantation.

UR - http://www.scopus.com/inward/record.url?scp=0027717985&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027717985&partnerID=8YFLogxK

M3 - Article

VL - 25

SP - 133

EP - 139

JO - Journal of Extra-Corporeal Technology

JF - Journal of Extra-Corporeal Technology

SN - 0022-1058

IS - 4

ER -