Complications of liver transplant

Craig, Elizabeth V.; Heller, Matthew T.

doi:10.1007/s00261-019-02340-5

Cited by 78 publications

(68 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Bu fazda fazla sıvı resusitasyonu bu dönemde hipervolemi gelişmesine, buna bağlı olarak da kardiyopulmoner fonksiyonlarda bozulma ve greft karaciğerin konjesyonuna yol açabilir. Bunun sonucunda postoperative dönemde uzamış weaning ve pulmoner komplikasyonlara neden olabilir [13,51] . [8] .…”

Section: Neohepatik Fazunclassified

Anesthesia for Liver Transplantation

Ersoy¹,

Çekmen²

2021

GKDA Derg

View full text Add to dashboard Cite

Orthotopic liver transplantation (OLT) is the gold standard treatment for patients with end-stage liver disease. Understanding of the multisystem physiology of end stage liver desease (ESLD) is fundamental to the management of transplant recipient. Since OLT is a very dynamic process, a multidisciplinary approach and optimization is essential in the perioperative period. During the management anesthesiologists should focus on significant hemodynamic instability, physiology, metabolic disturbance and coagulopathy of those patients. The aim of this review was to summarize peroperative and anesthesia management in line with the guidelines.

show abstract

Section: Neohepatik Fazunclassified

Anesthesia for Liver Transplantation

Ersoy¹,

Çekmen²

2021

GKDA Derg

View full text Add to dashboard Cite

show abstract

“… 2 , 3 HAT is reported to have an incidence of 2%–12% and presents most commonly in the early postoperative period. 4 A more subtle complication with significant impact on graft survival is in the form of hepatic artery stenosis (HAS). This problem develops in a more gradual manner and the median time until presentation is reported to be 100 days postoperatively.…”

Section: Introductionmentioning

confidence: 99%

“…This problem develops in a more gradual manner and the median time until presentation is reported to be 100 days postoperatively. 4 , 5 …”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 The biliary epithelium receives their sole blood supply from the peribiliary capillary plexus, and the flow through this microvasculature is determined by supply from the hepatic artery. 4 , 8 Therefore, a stenosis at a proximal arterial position will precipitate ischemia of the bile duct epithelium and can lead to biliary stricture (BS) formation, graft dysfunction, bilomas, and bile leaks. 4 , 9 , 10 Duplex ultrasound (US) findings can be suggestive of HAS; however, a definitive map of the arterial tree requires computed tomography (CT) or digital subtraction angiography (DSA) which identify the stenosis location and severity.…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 8 Therefore, a stenosis at a proximal arterial position will precipitate ischemia of the bile duct epithelium and can lead to biliary stricture (BS) formation, graft dysfunction, bilomas, and bile leaks. 4 , 9 , 10 Duplex ultrasound (US) findings can be suggestive of HAS; however, a definitive map of the arterial tree requires computed tomography (CT) or digital subtraction angiography (DSA) which identify the stenosis location and severity. 10 Several hypotheses exist regarding the cause of HAS.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

Hann

Seth

Mergental

et al. 2020

Transplantation Direct

View full text Add to dashboard Cite

Background. Hepatic artery stenosis (HAS) following liver transplantation results in hypoperfusion and ischemic damage to the biliary tree. This study aimed to investigate how vascular intervention, liver function test derangement, and time point of HAS onset influence biliary complications. Methods. A single-center retrospective study of adult patients that underwent primary liver transplantation. Patients were grouped according to the presence or absence of HAS and then into early (≤90 d) or late (>90 d) subgroups. Biliary complications comprised anastomotic (AS) or non ASs (NASs). Results. Computed tomography angiography confirmed HAS was present in 39 of 1232 patients (3.2%). This occurred at ≤90 and >90 days in 20 (1.6%) and 19 (1.5%), respectively. The incidence of biliary strictures (BSs) in the group with HAS was higher than the group without (13/39; 33% versus 85/1193; 7.1%, P = 0.01). BS occurred in 8/20 (40.0%) and 5/19 (26.3%) of the early and late groups, respectively. The need for biliary intervention increased if any liver function test result was ≥3× upper limit of normal (P = 0.019). Conclusions. BS occurs at a significantly higher rate in the presence of HAS. Onset of HAS at ≤90 or ≥90 days can both be associated with morbidity. Significant liver function test derangement at HAS diagnosis indicates a higher likelihood of biliary intervention for strictures.

show abstract

Liver Transplant as a Treatment of Primary and Secondary Liver Neoplasms

Gorji,

Brown,

Limkemann

et al. 2024

JAMA Surg

View full text Add to dashboard Cite

ImportanceLiver malignancies are an increasing global health concern with a high mortality. We review outcomes following liver transplant for primary and secondary hepatic malignancies.ObservationsTransplant may be a suitable treatment option for primary and secondary hepatic malignancies in well-selected patient populations.Conclusions and RelevanceMany patients with primary or secondary liver tumors are not eligible for liver resection because of advanced underlying liver disease or high tumor burden, precluding complete tumor clearance. Although liver transplant has been a long-standing treatment modality for patients with hepatocellular carcinoma, recently transplant has been considered for patients with other malignant diagnoses. In particular, while well-established for hepatocellular carcinoma and select patients with perihilar cholangiocarcinoma, transplant has been increasingly used to treat patients with intrahepatic cholangiocarcinoma, as well as metastatic disease from colorectal liver and neuroendocrine primary tumors. Because of the limited availability of grafts and the number of patients on the waiting list, optimal selection criteria must be further defined. The ethics of organ allocation to individuals who may benefit from prolonged survival after transplant yet have a high incidence of recurrence, as well as the role of living donation, need to be further discerned in the setting of transplant oncology.

show abstract

Complications of liver transplant

Cited by 78 publications

References 54 publications

Anesthesia for Liver Transplantation

Anesthesia for Liver Transplantation

Biliary Strictures Are Associated With Both Early and Late Hepatic Artery Stenosis

Liver Transplant as a Treatment of Primary and Secondary Liver Neoplasms

Contact Info

Product

Resources

About