Allogeneic hepatic transplantation using cadaveric donors with clinical application

Allogeneic liver grafts obtained from cadaveric donors were transplanted in 29 dogs, 3 pigs, and 1 human. Extracorporeal perfusion was used while the donor liver was excised, and asanguinous hypothermic perfusion through the hepatic artery and portal vein was continued until the venous effluent was clear. In contrast to the relatively long survival following canine hepatic allografting from anesthetized donors, the average survival following cadaveric canine orthotopic and heterotopic grafting was less than 1 1 2 days. Hepatocellular injury due to prolonged hypoxia is believed to have caused the “out-flow block” syndrome, venous congestion and death in almost all dogs. The anaerobic bacterial flora of the canine liver is believed to make it particularly susceptible to short periods of hypoxia. In contrast, the porcine and human liver appear to tolerate hypoxia for periods of over 3 hours without developing congestion. The experience with heterotopic liver grafting in a patient is presented with survival of 12 days.