Monitoring Leakage During Isolated Hepatic Perfusion
The toxicity of the drugs used during isolated hepatic perfusion, such as tumor necrosis factor a, necessitates the assessment of leakage. The liver is an organ that, apart from the vessels and the bile duct, can be separated completely from the surrounding body tissue. Leakage can still occur, however, with possible sites at the veins connecting to the caval vein. The caval vein should be freed as much as possible. Drug levels in the perfusate and venous blood can be determined only retrospectively; and because they can be interpreted in different ways they are not sufficient for measuring leakage. If radiolabeled albumin is injected into the perfusion circuit and a detector is placed over the centrifugal perfusion pump (used for the venovenous bypass over the blood reservoir) the accumulation in the systemic blood can be measured. Of all the methods used today this technique seems to be the most sensitive.
KeywordsToxicity Catheter Albumin Exter Erythro
Unable to display preview. Download preview PDF.
- Aigner K, Walther H, Tonn J, Wenzl A, Hechtel R, Merker G, Schwemmle K (1983) First experimental and clinical results of isolated liver perfusion with cytotoxics in metastases from colorectal primary. Cancer Res 86: 99–102Google Scholar
- Naredi P, Holmberg SB, Hafstrom L, Heath DD, Shalinsky DR, Howell SB (1992) Pharmacokinetics of cisplatin in an isolated liver perfusion system in humans. Reg Cancer Treat 4: 254–257Google Scholar
- Runia RD, De Brauw LM, Kothuis BJL, Pauwels EKJ, Van De Velde GJH (1987) Continuous measurement of leakage during isolated liver perfusion with a radiotracer. Nucl Med Bio 14: 113–118Google Scholar
- Stehlin JS, Glark RL, Dewey W (1961) Continuous monitoring of leakage during regional perfusion. Arch Surg 83: 165–171Google Scholar