[Hemodynamic effects of anesthetic agents and bypass flow during orthotopic liver transplantation in pigs].

Although the hemodynamics during orthotopic liver transplantation is unstable, it is very important for new liver to get well-controlled hemodynamics. Thus hemodynamic changes were studied, especially in relation to the influence of anesthetic agents and bypass flow in orthotopic liver transplantation in pig. Hemodynamic changes associated with NLA, GOS (sevoflurane) and GOF anesthesia were evaluated. It was difficult to maintain arterial pressure and to recover cardiac output with NLA after the bypass was removed. GOS, with which the hemodynamic condition was best maintained and no hepatotoxicity was manifest, proved the most useful of the three anesthetic agents. Hemodynamic studies based on bypass flow were made by comparing two groups, a high flow (31 +/- 4ml/kg/min) and a low flow (19 +/- 2ml/kg/min) groups, following the bypass model study conducted by 20, 30 and 40ml/kg/min. flow rates with the fixed infusion speed. In the high flow group, cardiac output and pulmonary arterial pressure were better maintained during the anhepatic phase and at the removal of the bypass. It is estimated that the low flow group was within the limits permitted, but beyond safety limits, also from the bypass model study. It is suggested that approximately 30ml/kg/min was the appropriate flow rate in pig.