Comparative Study Of Two Reperfusion Modes Affecting Liver Function And Biliary Complication At The Early Stage After Orthotopic Liver Transplantation

Objective: To prospectively compare the effects of two intraoperative reperfusion modes on liver function early after orthotopic liver transplantation (OLT) and the incidence of biliary complication within 3 months after transplantation.Methods: A total of 41 cases were randomly divided into sequential reperfusion group (Group A) and simultaneous reperfusion group (Group B). The parameters including liver function and blood coagulation were observed at day 1 preoperatively, intraoperative anhepatic phase, donor liver reflow and at days 1-5 postoperatively.The incidence of biliary complication was observed within 3 months after transplantation.Results:1. The prothrombin time (PT) in Group A was (24.3±5.0s), longer than PT in Group B (20.5±3.9s) at day 1 postoperatively, with statistical difference (P=0.011). There were no statistical differences for other parameters between both groups.2. No difference between the group was observed regarding the incidence of biliary complication during follow-up.However,more nonanastomotic biliary strictures were observed in Group A,more biliary anastomotic strictures were observed in Group B. Conclusions:1. In OLT, the donor livers can synthesize blood coagulation factors earlier in simultaneous reperfusion of portal vein and hepatic artery. Besides, there is no significant difference regarding recovery of liver function early after OLT under two intraoperative reperfusion modes.2. No difference between the group was observed regarding the incidence of biliary complication within 3 months after transplantation.However,more nonanastomotic biliary strictures were observed in Group A,more biliary anastomotic strictures were observed in Group B.