Compound sodium lactate

For all dogs, food was removed at least eight hours prior to the procedure but access to water provided until premedication. Dog were anesthetized by a veterinary anesthesiologist (AR) using a standardized protocol. Premedication with methadone 0.3 mg/kg (Ilium Methadone 10 mg/mL, Troy Laboratories, Glendenning, NSW, Australia) IM was performed 30 min prior to induction of general anesthesia with alfaxalone (Alfaxan injection 10 mg/mL, Jurox, Glendinning, NSW, Australia) 2.2–3.2 mg/kg intramuscularly. Endotracheal intubation was used to maintain anesthesia with isoflurane (I.S.O., Veterinary Companies of Australia Pty Ltd, Kings Park, NSW, Australia) in 30% oxygen through a circle rebreathing system. End tidal isoflurane was maintained at 1.3–1.4%. Infusion of a balanced isotonic crystalloid solution (Compound Sodium Lactate, Baxter Healthcare, Toongabbie, NSW, Australia) was provided at 10 mL/kg/hour IV throughout anesthesia, along with IV fentanyl (Fentanyl injection 50 µg/mL, AstraZeneca, Macquarie Park, NSW, Australia) 2 µg/kg/hour. Arterial carbon dioxide tension was maintained between 35 and 45 mmHg by provision of mechanical ventilation by an anesthesia workstation (Datex-Ohmeda S/5 Aespire Anaesthesia Machine, GE Healthcare, Chicago, IL, USA). Active warming maintained esophageal temperature between 36.0 and 38.0 °C.

Before undergoing NESLiP, all livers were flushed with compound sodium lactate (Hartmann’s solution, Baxter Healthcare Ltd, United Kingdom) at room temperature to de-air the cannulas and warm and preload the liver with lactate. A small sample of vena caval effluent from this preperfusion flush from 20 consecutive livers was also collected for D-dimer analysis to assess whether fibrin was present in livers before NESLiP began.