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British Journal of Anaesthesia, 1990, Vol. 64, No. 1 42-44
© 1990 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

CHANGES IN ALVEOLAR-ARTERIAL OXYGEN PARTIAL PRESSURE DIFFERENCE DURING ORTHOTOPIC LIVER TRANSPLANTATION

K. R. BURCHETT, M.B., CH.B., F.F.A.R.C.S., M. F. SMITH and G. R. PARK, M.A., F.F.A.R.C.S.

Department of Anaesthesia, Addenbrooke's Hospital Hills Road, Cambridge CB2 2QQ

Correspondence to G.R.P.

Changes in the alveolar-arterial oxygen partial pressure difference (PAO2–PaO2) were measured in 39 patients undergoing orthotopic liver transplantation without veno—arterial or veno—venous bypass. The operation can be divided into an initial dissection phase, an anhepatic phase when the hepatic artery, portal vein and vena cava are clamped, and a post-anhepatic phase after the vascular clamps are released. There was an initial increase in (PAO2–PaO2) during the dissection phase, followed by an immediate decrease when the liver was removed. This decrease continued throughout the anhepatic period, but a further increase in (PAO2–PaO2) occurred after release of all the vascular clamps and during abdominal closure.


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