간불전견의 체외간관류에 대한 연구

Abstract

A variety of extracorporeal hepatic support in recent years have been used in patient with hepatic coma due to acute hepatic necrosis. This procedure is probably the available method of treatment of hepatic coma. but its therapeutic effectiveness. immunological implication and technical problem have not been fully evaluated. Homologous extracorporeal liver perfusion was performed in dogs. weighing about 12kg. of hepatic failure incuced by carryng out a common bile duct ligation. and their hemodynamic. biochemical and pathological findings were studied. The results were as follows; 1) In most cases there was a tendency to develop acidosis and hypotension. A group which was not treated with fluid and blood volume replacement prior to perfusion. liver blood flow diminished markedly and inadequate liver perfusion was obtained. 2) In the group of adequate liver perfusion. serum bilirubin and blood ammonia levels decreased rapidly the course of liver perfusion. But SGPT. SGOT and protein levels were not changed efficiently. 3) Liver weight increased from 12 to 28% during two hour period of liver perfusion. 4) Pathological findings on .perfused liver revealed mild perisinusoidal congestion and focal inflammatory cell infiltration but hepatic lobule was well preserved. There were no degenerative changes or necrosis of liver cells.