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Relevant changes in cerebral circulation occur during “Piggy Back” liver transplantation. Particularly at the washout-reperfusion time the cerebral perfusion suddenly changes from its lowest to its highest values. Further investigation is required to evaluate whether patients with the greatest change in cerebral oxygenation at this time point will suffer neurological complications after transplantation. It is remarkable that TOI and THI levels are higher in the most compromised patients, perhaps because of an increased CO and, mainly, because of a decreased vascular resistance.

Celsior solution does not aggregate erythrocytes, whereas Wisconsin solution massively does. This feature could make CS preferable to UW during organ procurement.

We have used a relatively simple model of hypoxia that triggers adaptive structural changes in the cerebral microvasculature to study the process of physiological angiogenesis. This model can be used to obtain mechanistic data for the processes that probably underlie the dynamic structural changes that occur in learning and the control of oxygen availability to the neurovascular unit. These mechanisms are broadly involved in a wide variety of pathophysiological processes. This is the vascular component to CNS functional plasticity, supporting learning and adaptation. The angiogenic process may wane with age, contributing to the decreasing ability to survive metabolic stress and the diminution of neuronal plasticity.

Direct cooling of the cerebral cortex with the ChillerStrip™ to 15°C followed by spontaneous rewarming to 37°C is safe. Direct cooling of the brain reduces the severity of the ischemic insult as judged by the reduction in the hyperemia after reperfusion which appeared to be directly related to the temperature of the brain.