Closed Chest Bypass for Liver Transplantation

  • Linda E. McLean
  • Scott M. Kreger
  • Christina T. Mora


Preliminary investigation into the feasibility of organ replacement as a therapeutic modality for treatment of irreversible liver disease began in the early 1950s. Welch, in 1955, reported a technique of heterotopic liver transplantation by insertion of a donor graft into the pelvis of a dog, without removal of the native organ.1 In 1956, the report of an experimental orthotopic liver transplantation (OLT) provided the first venture at whole organ replacement.2 Individual groups at Boston (Moore) and Chicago (Starzl) began extensive research on liver transplantation in the canine model,3,4 leading to the first attempt at human OLT in 1963. Relatively long-term success in human transplantation did not occur until 1967, however, when a recipient, one-and-a-half years old, survived for 13 months.5


Liver Transplantation Primary Biliary Cirrhosis Orthotopic Liver Transplantation Biliary Atresia Centrifugal Pump 
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  1. 1.
    Welch CS. A note on transplantation of the whole liver of dogs. Transplant Bull 1955;2:54–55.Google Scholar
  2. 2.
    Cannon JA. Organs (communication). Transplant Bull 1956;3:7.Google Scholar
  3. 3.
    Starzl TE, Kaupp HA, Brock DR, et al. Reconstructive problems in canine liver homotransplantation with special reference to the postoperative role of the hepatic venous flow. Surg Gynecol Obstet 1960;11:733–743.Google Scholar
  4. 4.
    Moore FD. Experimental whole organ transplantation of the liver and the spleen. Ann Surg 1960;152:374–387.PubMedGoogle Scholar
  5. 5.
    Starzl TE, Iwatsuki S, VanThiel DH, et al. Evolution of liver transplantation. Hepatology 1982;2:614–636.PubMedCrossRefGoogle Scholar
  6. 6.
    Smith SL. Liver transplantation. In: Smith SL, ed. Tissue 26. and Organ Transplantation: Implications for Professional Nursing Practice. St Louis: Mosby Yearbook; 1990:273.Google Scholar
  7. 7.
    Starzl TE, Marchiaro TL, Vonkulla KN, et al. Homotrans- 27. plantation of the liver in humans. Surg Gynecol Obstet 1963; 117:659–676.PubMedGoogle Scholar
  8. 8.
    Vanthiel DG, Schade RR, Hakala TR, et al. Liver procure- 28. ment for orthotopic transplantation: an analysis of the Pittsburgh experience. Hepatology 1984;4:66S–71S.CrossRefGoogle Scholar
  9. 9.
    Stratta RJ, Wood RP, Langhas AN, et al. The impact of ex- 29. tended preservation on clinical liver transplantation. Transplantation 1990;50:438–443.PubMedCrossRefGoogle Scholar
  10. 10.
    Starzl TE. Liver Transplantation. Chicago: Yearbook Med Pub Inc; 1990:14–18.Google Scholar
  11. 11.
    Kalayoglu M, Hoffmann RM, D’Alessandro AM, et al. Re- 31. sults of extended preservation of the liver for clinical transplantation. Transplant Proc 1989;21:3487–3488.PubMedGoogle Scholar
  12. 12.
    Lopez RR, Wright K, Donovan KL, et al. Overview of liver 32. transplantation for the perfusionist. J Extracorp Technol 1992;24:26–32.Google Scholar
  13. 13.
    Mendez IB Leddomado E. Orthotopic liver transplantation 33. in children. Mt Sinai JMed 1989;56:71–75.Google Scholar
  14. 14.
    Hooks MA. Immunosuppressive agents used in transplantation. In: Smith SL, ed. Tissue and Organ Transplantation: 34. Implications for Professional Nursing Practice. St Louis: Mosby Year Book; 1990:48–80.Google Scholar
  15. 15.
    Iwatsuki S, Starzl TE, Todo S, et al. Liver transplantation 35. for treatment of bleeding esophageal varices. Surgery 1988; 104:697–705.PubMedGoogle Scholar
  16. 16.
    Millis JM, Baquerizo A, Saleh S, et al. Preservation of renal function using OLT in liver transplant patients. Transplant 36. Proc 1989;21:3551–3552.Google Scholar
  17. 17.
    Fabregat J, Fradera R, Jaurrieta E, et al. Clinical results of 37. quadruple drug immunosuppression in liver transplantation. Transplant Proc 1992;24:148–149.PubMedGoogle Scholar
  18. 18.
    National Institutes of Health Consensus Development Con- 38. ference Statement. Liver Transplant Hepatol 1984;4:107S–110S.Google Scholar
  19. 19.
    Roberts JP, Forsmark C, Lake JR, et al. Liver transplanta- 39. tion today. Annu Rev Med 1989;40:287–303.PubMedCrossRefGoogle Scholar
  20. 20.
    Starzl TE, Demetris AJ, Van Thiel D. Liver transplantation. NEngl JMed 1989;321:1014–1022.CrossRefGoogle Scholar
  21. 21.
    Smith SL. Liver transplantation. In: Smith SL, ed. Tissue and Organ Transplantation: Implications for Professional Nursing Practice. St Louis: Mosby Yearbook; 1990:276–283.Google Scholar
  22. 22.
    Samuel D, Bismuth A, Serres C, et al. HBV infection after liver transplantation in HBsAg positive patients: experience with long-term immunoprophylaxis. Transplant Proc 1991; 23:1492–1494.PubMedGoogle Scholar
  23. 23.
    Shah G, Demetris AJ, Gravaler JS, et al. Incidence, prevalence, and clinical course of hepatitis C following liver transplantation. Gastroenterology 1992;103:323–329.PubMedGoogle Scholar
  24. 24.
    Shaw BW, Martin DJ, Marquez JM, et al. Venous bypass in clinical liver transplantation. Ann Surg 1984;200:524–534.Google Scholar
  25. 25.
    Brown M, Gunning T, Roberts C, et al. Biochemical markers of renal perfusion are preserved during liver transplantation with veno-venous bypass. Transplant Proc 1991;23: 1980–1981.PubMedGoogle Scholar
  26. 26.
    Caine RY, McMaster P, Smith DP, et al. Use of partial cardiopulmonary bypass during the anhepatic phase of orthotopic liver grafting. Lancet 1979;2:612–614.Google Scholar
  27. 27.
    Dixon CM, Magovern GJ. Evaluation of the bio-pump for long-term cardiac support without heparinization. J Extracorp Technol 1982;14:331–336.Google Scholar
  28. 28.
    Griffith BP, Byers WS, Hardesty RL, et al. Venovenous bypass without systemic anticoagulation for transplantation of the human liver. Surg Gynecol Obstet 1985;160:270–272.PubMedGoogle Scholar
  29. 29.
    Caine RY, Williams R, Rolles K. Liver transplantation in the adult. World J Surg 1986;10:422–431.CrossRefGoogle Scholar
  30. 30.
    Kang YG, Freeman JA, Aggarwal S, et al. Hemodynamic instability during liver transplantation. Tranplant Proc 1989;21:3489–3492.Google Scholar
  31. 31.
    Eason J, Tan K, Howard E, et al. Comparative hemodynamics of venovenous and venoarterial bypass during liver transplantation in the pig. Transplant Proc 1989;21:35–25.Google Scholar
  32. 32.
    Taura P, Beltran J, Garcia-Valdecasas JC, et al. The need for venovenous bypass in orthotopic liver transplantation. Transplantation 1991;52:730–733.PubMedCrossRefGoogle Scholar
  33. 33.
    Shaw BW. Some further notes on venous bypass for orthotopic transplantation of the liver. Transplant Proc 1987; 19(suppl 3):13–16.PubMedGoogle Scholar
  34. 34.
    Veroli P, El Hage C, Ecoffey C. Does adult liver transplantation without venovenous bypass result in renal failure? Anesth Analg 1992;75:489–494.PubMedCrossRefGoogle Scholar
  35. 35.
    Stock PG, Payne WD, Ascher NL, et al. Rapid infusion technique as a safe alternative to venovenous bypass in orthotopic liver transplantation. Tranplant Proc 1989;21: 2322–2325.Google Scholar
  36. 36.
    Wall WJ, Grant DR, Duff JH. Liver transplantation without venovenous bypass. Transplantation 1987;43:56–61.PubMedCrossRefGoogle Scholar
  37. 37.
    Merritt WT, Beattie C, Peck R, et al. Vena cavai pressure gradients during liver transplantation. Transplantation 1990;50:336–338.PubMedGoogle Scholar
  38. 38.
    Shaw BW, Martin DJ, Marquez JM, et al. Advantages of venovenous bypass during orthotopic transplantation of the liver. Semin Liver Disease 1985;5:344–348.CrossRefGoogle Scholar
  39. 39.
    Kelley SD. Venovenous bypass during liver transplantation. Anesth Analg 1992;75:481–483.PubMedCrossRefGoogle Scholar
  40. 40.
    Carton EG, Plevak DJ, Kranner PW, et al. Perioperative care of the liver transplant patient: Part 2. Anesth Analg 1994;78:382–399.PubMedCrossRefGoogle Scholar
  41. 41.
    Khoury GF, Mann ME, Porot MJ, et al. Air embolism associated with veno-venous bypass during orthotopic liver transplantation. Anesthesiology 1987;848–851.Google Scholar
  42. 42.
    Paulsen AW, Whitten CW, Ramsay MA, et al. Considerations for anesthetic management during veno-venous bypass in adult hepatic transplantation. Anesth Analg 1989;68:489–496.PubMedCrossRefGoogle Scholar
  43. 43.
    Prager MC, Gregory GA, Ascher NL, et al. Massive venous air embolism during orthotopic liver transplantation. Anesthesiology 1990;72:198–200.PubMedCrossRefGoogle Scholar
  44. 44.
    Martin BJ, Riley JB. Thrombus formation in centrifugal pumps. J Extracorporp Technol 1992;24:20–25.Google Scholar
  45. 45.
    Magovern GJ, Park SB, Maher TD. Use of a centrifugal pump without anticoagulants for postoperative left ventricular assist. World J Surg 1985;9:25–36.PubMedCrossRefGoogle Scholar
  46. 46.
    van der Hulst VPM, Henny CP, Moulijn AC, et al. Venovenous bypass without systemic heparinization using a centrifugal pump: A blind comparison of a heparin bonded circuit versus a non heparin bonded circuit. J Cardiovasc Surg 1989;30:118–123.Google Scholar
  47. 47.
    Morgan CH, Penner JA. Bleeding complications during surgery: Part II, Acquired hemorrhage disorders. Lab Med 1986;17:262–266.Google Scholar
  48. 48.
    Smith SL. Liver transplantation. In: Smith SL, ed. Tissue and Organ Transplantation: Implications for Professional Nursing Practice. St Louis: Mosby Yearbook; 1990:286–287.Google Scholar
  49. 49.
    Harper PL, Luddington RJ, Jennings I, et al. Coagulation changes following hepatic revascularization during liver transplantation. Transplantation 1989;48:603–607.PubMedGoogle Scholar
  50. 50.
    Caine R. Liver Transplantation The Cambridge King’s College Hospital Experience. 2nd ed. Orlando: Grune and Stratton Ltd; 1987:193–197.Google Scholar
  51. 51.
    Kristiansson M, Lantz B, Gulliksson H, et al. Autotransfusion in liver transplantation. Transplant Proc 1989;21:35–38.Google Scholar
  52. 52.
    Gartner JC, Zitelli BJ, Malatack JJ, et al. Orthotopic liver transplantation in children: two year experience with 47 patients. Pediatrics 1984;74:140–145.PubMedGoogle Scholar
  53. 53.
    Vanthiel DH. Liver transplantation. Pediatric Ann 1985;14: 474–480.Google Scholar
  54. 54.
    Starzl TE. Liver Transplantation. Chicago: Yearbook Med Pub Inc; 1990:119–130.Google Scholar
  55. 55.
    Shaw BW. Transplantation of the liver. In: Gitnick G, La Brecque DR, Moody FG, eds. Diseases of the Liver and Biliary Tract. St. Louis: Mosby Yearbook; 1989:635–638.Google Scholar
  56. 56.
    Musial J, Gluszko P, Edmunds H. Evaluation of surface-bound heparin and platelet inhibition in a centrifugal pump left ventricular assist system. World J Surg 1985; 9(1):7277.CrossRefGoogle Scholar
  57. 57.
    Mendez IB, Leddomado E. Orthotopic liver transplantation in children. The Mount Sinai Journal of Medicine 1989; 56(1):71–75.Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • Linda E. McLean
  • Scott M. Kreger
  • Christina T. Mora

There are no affiliations available

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