Liver transplant without a venovenous bypass.

The problem whether to use or not to use a venovenous bypass in liver transplantation is the point of a discussion and the subject of controversies among anaesthetists and transplant surgeons. Some emphasize the advantages of using a venovenous bypass such as stabilization of the blood flow resulting from maintaining appropriate venous inflow to the heart, maintenance of perfusion pressure in the kidneys, decrease in bleeding and greater comfort for the operating surgeon. The opponents observe possible complications such as air embolism, thrombi of cannulated vessels, a hypothermia hazard, prolongation of the operation. The operation without application of extrasystemic venous circulation could be a good method especially for the patients with no circulatory failure before the operation but for experienced anaesthetists and transplant surgeons only.