Isolated Liver Perfusion for Hepatic Tumors

The contributions in this book were originally presented at the workshop Research and Clinical Application of Isolated Liver Perfusion for Hepatic Tumors held on 28 February to 1 March 1997 in Hanover, Germany. The workshop was planned to bring together groups working with isolated liver perfusion techniques worldwide. Experts from various countries were invited to pre­ sent and discuss their experimental data and clinical results. USA par­ Groups from Japan, The Netherlands, Sweden and the ticipated. At the beginning, oncologists, surgeons and patholo­ gists presented possible indications and the oncological back­ ground for therapeutic isolated liver perfusion from their points of view. Based on data from previous studies about loco regional chemotherapy and based on the pathology of metastasis, it could be concluded that there is a place for isolated liver perfusion in the therapy of liver cancer. Second, different surgical techniques of isolated liver perfusion were presented. These techniques var­ ied from a percutaneous approach with extracorporeal chemofil­ tration to extended open abdominal surgery. Perfusion of the liv­ er without a considerable amount of drug reaching the systemic circulation proved to be possible. The complex procedure with complicated extracorporeal perfusion technique represented a disadvantage of the methods presented. Further studies should simplify the technical and surgical aspects. Intraoperative and postoperative management of . patients undergoing isolated liver perfusion were also discussed. Coagulopathy was one important aspect which can occur during isolated liver perfusion. The per­ centage of leakage determined systemic side effects.