| Partial portal arterialization for hepatic arterial thrombosis after living-donor liver transplant. | |
| | |
MedLine Citation:
|
PMID: 22631061 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVES: The most serious, life-threatening complication after living-donor liver transplant is a hepatic arterial thrombosis. Although possible therapies for acute hepatic arterial thrombosis include revascularization to salvage the graft, or retransplant, these may be difficult to perform owing to technical aspects and donor shortages. Previously, we reported the usefulness of partial portal arterialization in such cases. MATERIALS AND METHODS: Four cases of partial portal arterialization for hepatic arterial occlusion after living-donor liver transplant were reviewed. The surgical procedure of partial portal arterializations involves making an arteriovenous shunt via a side-to-side anastomosis, using mesenteric vessels approximately 2 mm in diameter. RESULTS: After partial portal arterialization, hepatic arterial flow was not detected, but graft injury owing to hypoxia gradually improved in all cases. In 1 case, occlusion of the arteriovenous shunt itself and the collateral artery to the graft were identified by angiography 45 days after partial portal arterialization. In another case, massive ascites, pleural effusion, and variceal changes of the mesenteric veins owing to portal hypertension were identified, and surgical closure of the shunt was performed 152 days after partial portal arterialization. In the other 2 cases, there were no definite problems related to partial portal arterialization, but the patients died owing to other complications. CONCLUSIONS: When hepatic arterial thrombosis occurs after living-donor liver transplant, revascularization should be performed first. However, this sometimes may be difficult, as when the arterial dissection reaches into the graft. Partial portal arterialization is an easy and effective surgical procedure. Therefore, partial portal arterialization appears to be a useful option to gain time until collateral arterial vessels develop or retransplant, even if revascularization cannot be performed. |
| | |
Authors:
|
Hironori Hayashi; Hiroyuki Takamura; Takashi Tani; Isamu Makino; Hisatoshi Nakagawara; Hidehiro Tajima; Hirohisa Kitagawa; Ichiro Onishi; Koichi Shimizu; Tetsuo Ohta |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation Volume: 10 ISSN: 2146-8427 ISO Abbreviation: Exp Clin Transplant Publication Date: 2012 Jun |
Date Detail:
|
Created Date: 2012-05-28 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101207333 Medline TA: Exp Clin Transplant Country: Turkey |
Other Details:
|
Languages: eng Pagination: 247-51 Citation Subset: IM |
Affiliation:
|
From the Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Neurologic complications of renal transplant.
Next Document: Serum insulinlike growth factor-1 and its binding protein-3 levels in children with cirrhosis waitin...