TY - CHAP M1 - Book, Section TI - The Piggyback Technique for Liver Transplantation A1 - Sterkenburg, A. A1 - Schemmer, Peter A2 - Molmenti, Ernesto Pompeo A2 - SantibaƱes, Martin de A2 - SantibaƱes, Eduardo de Y1 - 2021 N1 - T2 - Liver Transplantation: Operative Techniques and Medical Management AB - With the introduction of cyclosporine in 1969, survival rates after liver transplantation (LT) improved drastically;1 however, mortality still remained high due to challenges encountered during the anhepatic phase when the inferior vena cava (IVC) is first clamped and subsequently removed, along with the diseased liver. Together with the interruption of the portal venous blood flow, there is a dramatic decrease in the volume of the central venous return to the heart, which in turn, decreases the cardiac output and arterial pressure. Furthermore, when these events occur with the backdrop of hypoperfusion of critical organs and extensive bleeding from venous collaterals, the consequences can have disastrous implications. Additionally, a systemic increase in potassium levels and acidosis usually occur during reperfusion of the liver graft.2,3 SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1180112892 ER -