This is the first detailed description from the anesthesiologic management during isolated hypoxic hepatic perfusion (IHHP), a complex way of regional cancer therapy. During IHHP, there is full clamping of the caval vein and aorta just beneath the diaphragm. It also means subsequent complete isolation of the hepatic vasculature to enable simultaneous administration of high-dose chemotherapy (melfalan) by perfusion. After completion of the perfusion and subsequent release of both clamps, abdominal reperfusion follows. We examined hemodynamic and metabolic changes during the IHHP procedure in 22 patients with metastases in the liver during the period 2002-2009. Conclusions: No Please check whether the heading "Conclusions" can be deleted. cardiac, gastrointestinal, spinal or nephrologic complications occurred during these procedures. Since this IHPP procedure can be performed safely by an experienced team; it might be worth to explore the use of high simultaneous clamping in facilitating other abdominal procedures.

doi.org/10.1007/978-1-4614-1566-4_19, hdl.handle.net/1765/52757
Department of Surgery

van den Bosch, J. B., Verhoef, K., Teng-van de Zande, F. L., Bakker, J., Erdmann, W., & Tenbrinck, R. (2012). Isolated hypoxic liver perfusion with melfalan in humans and its anesthesiologic aspects. doi:10.1007/978-1-4614-1566-4_19