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Review
. 2023 Feb;72(2):113-120.
doi: 10.1007/s00101-022-01235-3. Epub 2022 Dec 7.

[Anesthesiological and postinterventional management in percutaneous hepatic melphalan perfusion (chemosaturation)]

[Article in German]
Peter Kliem  1 , Sebastian Ebel  2 , Robert Werdehausen  1 , Felix Girrbach  1 , Denis Bösemann  3 , Florian van Bömmel  4 , Timm Denecke  2 , Sebastian Stehr  1 , Manuel F Struck  5
Affiliations
Review

[Anesthesiological and postinterventional management in percutaneous hepatic melphalan perfusion (chemosaturation)]

[Article in German]
Peter Kliem et al. Anaesthesiologie. 2023 Feb.

Abstract
in English, German

Percutaneous hepatic melphalan perfusion (PHMP) is a last-line treatment of inoperable primary or secondary liver tumors. Selective perfusion and saturation (chemosaturation) of the liver with the chemotherapeutic agent melphalan is performed via catheterization of the hepatic artery without affecting the rest of the body with its cytotoxic properties. Using an extracorporeal circulation and balloon occlusion of the inferior vena cava, the venous hepatic blood is filtered and returned using a bypass procedure. During the procedure, considerable circulatory depression and coagulopathy are frequent. The purpose of this article is to review the anesthesiological and postprocedural management of patients undergoing PHMP with consideration of the pitfalls and special circumstances.

Die perkutane hepatische Perfusion mit dem Chemotherapeutikum Melphalan (PHMP) ist eine Letztlinientherapie bei Patienten mit inoperablen primären oder sekundären Lebertumoren. Dabei wird die Leber transarteriell mit Melphalan perfundiert und aufgesättigt (Chemosaturation), mit dem Ziel, die Lebertumoren selektiv und ohne dessen systemische zytotoxische Eigenschaften zu behandeln. Über einen Extrakorporalkreislauf und eine Ballonokklusion der V. cava inferior wird das venöse hepatische Blut hämofiltriert und venös zurückgeleitet. Verfahrensbedingt kommt es dabei zu einer ausgeprägten Kreislaufdepression und einer Störung der plasmatischen Gerinnung. In diesem Artikel wird das anästhesiologische und postinterventionelle Management bei Patienten mit PHMP beschrieben und auf Fallstricke und Besonderheiten hingewiesen.

Keywords: Angiography; Chemosaturation; Extracorporeal circulation; Liver tumors; Melphalan.

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References

    1. Abram J, Klocker J, Innerhofer-Pompernigg N, et al. Verletzungen herznaher Gefäße durch zentralvenöse Katheter. Anaesthesist. 2016;65(11):866–871. doi: 10.1007/s00101-016-0226-8. - DOI - PubMed
    1. American Society of Anesthesiologists Practice guidelines for central venous access 2020: an updated report by the American society of anesthesiologists task force on central venous access. Anesthesiology. 2020;132(1):8–43. doi: 10.1097/ALN.0000000000002864. - DOI - PubMed
    1. Artzner C, Mossakowski O, Hefferman G, et al. Chemosaturation with percutaneous hepatic perfusion of melphalan for liver-dominant metastatic uveal melanoma: a single center experience. Cancer Imaging. 2019;19(1):31. doi: 10.1186/s40644-019-0218-4. - DOI - PMC - PubMed
    1. Aurshina A, Hingorani A, Alsheekh A, et al. Placement issues of hemodialysis catheters with pre-existing central lines and catheters. J Vasc Access. 2018;19(4):366–369. doi: 10.1177/1129729818757964. - DOI - PubMed
    1. Beheshti MV, Denny DF, Glickman MG, et al. Percutaneous isolated liver perfusion for treatment of hepatic malignancy: preliminary report. J Vasc Interv Radiol. 1992;3(3):453–458. doi: 10.1016/s1051-0443(92)71988-5. - DOI - PubMed

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