Basic study on hepatic resection under partial perfusion cooling.

To improve liver quality after reperfusion following partial hepatectomy under total or partial cooling of the liver (HPC), a new perfusion solution containing 100 mM L-histidine (KM solution) was developed. The livers of Lewis rats were removed and perfused for 2 hours at 20 degrees C with lactated Ringer's (LR) solution (group A) or the KM solution (group B). They were reperfused with rat blood at 37 degrees C at a perfusion pressure of 5 cmH2O while monitoring the portal and peripheral tissue blood flows. At the end of reperfusion, bile production, lactate dehydrogenase (LDH) secretion, and tissue adenosine triphosphate (ATP) was measured. Recovery of portal and peripheral tissue blood flows of the group B livers after reperfusion were significantly better than those of group A. Viability of the group B livers, assessed by bile production, tissue ATP value, and LDH release, was preserved better than that of group A livers. In situ total liver perfusion with LR (group C) and KM (group D) solutions for 1 hour at 20 degrees C followed by partial hepatectomy of the left lateral lobe was performed. The 1-week survivals of the group C and D rats were 25% and 100%, respectively (p < 0.05). It was concluded that KM solution is suitable for HPC.