Significance and causes of histamine release during orthotopic homologous liver transplantation in the Pig

Abstract

The question, whether histamine release has a patho-physiological significance during orthotopic homologous liver transplantation in pigs, was investigated in 31 recipients and donors and in 7 isolated perfused livers. The acute arterial hypotension occurring in the revascularization phase of this operation was greatly diminished by the administration of 2 mg/kg chlorphenoxamine. A significant increase of the plasma histamine concentration during this phase of operation and a strong hypotensive effect of corresponding plasma histamine levels in pigs, as determined after injection of 48/80, also support the view, that histamine release may contribute to critical circulatory situations during liver transplantations.

As causes of hsitamine release in various degress during this operation, anaesthesia, manipulations at the stomach and gut, passage of the blood through the extracorporeal by-pass and the ischaemia followed by a sudden warming of the liver were shown. The role of other vasoactive substances and biophysical mechanisms for the development of hypotension in the revascularization phase is discussed, but the significance cannot be determined at this time.