Abstract
This is the first detailed description from the anesthesiologic management during isolated hypoxic hepatic perfusion (IHHP), a complex way of regional cancer therapy. During IHHP, there is full clamping of the caval vein and aorta just beneath the diaphragm. It also means subsequent complete isolation of the hepatic vasculature to enable simultaneous administration of high-dose chemotherapy (melfalan) by perfusion. After completion of the perfusion and subsequent release of both clamps, abdominal reperfusion follows. We examined hemodynamic and metabolic changes during the IHHP procedure in 22 patients with metastases in the liver during the period 2002–2009. Conclusions: No Please check whether the heading “Conclusions” can be deleted. cardiac, gastrointestinal, spinal or nephrologic complications occurred during these procedures. Since this IHPP procedure can be performed safely by an experienced team; it might be worth to explore the use of high simultaneous clamping in facilitating other abdominal procedures.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Siesling S, van Dijck JA et al (2003) Trends in incidence of and mortality from cancer in the Netherlands in the period 1989–1998. Working group of the Netherlands cancer registry. Eur J Cancer 39(17):2521–2530
Penna C, Nordlinger B (2002) Surgery of liver metastases from colorectal cancer new promises. Br Med Bull 64:127–140
Verhoef C, De Wilt et al (2008) Isolated hypoxic hepatic perfusion with retrograde outflow in patients with irresectable liver metastases; a new simplified technique in isolated hepatic perfusion. Ann Surg Oncol 15(5):1367–1374
Aniset L, Knitschke R, Frietsch T (2010) Narkosetiefenmessung in der anästhesie. Anasthesiol Intensivmed Notfallmed Schmerzther 45:230–237
Hofland J, Tenbrinck R et al (2002) Cardiovascular effects of simultaneous occlusion of the inferior vena cava and aorta in patients treated with hypoxic abdominal perfusion for chemotherapy. Br J Anaesth 88(2):193–198
Gouvêa G, Diaz R et al (2010) Right ventricular ejection fraction during orthotopic liver transplantation: Does anesthetic technique make a difference? J Crit Care 25(4):657.e1–657.e6
Zheng SS et al (2002) Functional changes of the heart and lung in perioperative period of orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int 1:335–339
Saner FH et al (2010) How far can we go with positive end-expiratory pressure (PEEP) in liver transplant patients? J Clin Anesth 22:104–109
Tritapepe L, Landoni G, Guarracino F et al (2007) Cardiac protection by volatile anaesthetics: a multicentre randomized controlled study in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. Eur J Anaesthesiol 24:323–331
Yan S et al (2010) Outcomes and mechanisms of ischemic preconditioning in liver transplantation. Hepatobiliary Pancreat Dis Int 9:346–354
Gottschalk A (2010) Perioperative organprotektion – regionalanästhesie: Die rolle der thorakalen epiduralanästhesie. Anasthesiol Intensivmed Notfallmed Schmerzther 45:264–269
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this paper
Cite this paper
van den Bosch, J.B., Verhoef, C., de Zande, F.L.Tv., Bakker, J., Erdmann, W., Tenbrinck, R. (2012). Isolated Hypoxic Liver Perfusion with Melfalan in Humans and Its Anesthesiologic Aspects. In: Wolf, M., et al. Oxygen Transport to Tissue XXXIII. Advances in Experimental Medicine and Biology, vol 737. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1566-4_19
Download citation
DOI: https://doi.org/10.1007/978-1-4614-1566-4_19
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-1565-7
Online ISBN: 978-1-4614-1566-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)