Liver abscess developed after cadaveric liver transplantation due to ligation of an accessory right hepatic artery of the donor graft

Yu, Young Dong; Byun, Geon Young; Suh, Soon Yong

doi:10.4174/jkss.2012.83.4.246

Cited by 14 publications

(10 citation statements)

References 9 publications

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“…Aside from split-liver grafts, non-reconstruction of an accessory hepatic artery (usually right or left hepatic artery) or accidental occlusion of bile ducts during graft preparation increases the risk of HA, usually limited [63].…”

Section: Post-transplantation Hepatic Abscessmentioning

confidence: 99%

Hepatic abscess: Diagnosis and management

Lardière-Deguelte

Ragot

Amroun

et al. 2015

Journal of Visceral Surgery

224

247

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Microbial contamination of the liver parenchyma leading to hepatic abscess (HA) can occur via the bile ducts or vessels (arterial or portal) or directly, by contiguity. Infection is usually bacterial, sometimes parasitic, or very rarely fungal. In the Western world, bacterial (pyogenic) HA is most prevalent; the mortality is high approaching 15%, due mostly to patient debilitation and persistence of the underlying cause. In South-East Asia and Africa, amebic infection is the most frequent cause. The etiologies of HA are multiple including lithiasic biliary disease (cholecystitis, cholangitis), intra-abdominal collections (appendicitis, sigmoid diverticulitis, Crohn's disease), and bile duct ischemia secondary to pancreatoduodenectomy, liver transplantation, interventional techniques (radio-frequency ablation, intra-arterial chemo-embolization), and/or liver trauma. More rarely, HA occurs in the wake of septicemia either on healthy or preexisting liver diseases (biliary cysts, hydatid cyst, cystic or necrotic metastases). The incidence of HA secondary to Klebsiella pneumoniae is increasing and can give rise to other distant septic metastases. The diagnosis of HA depends mainly on imaging (sonography and/or CT scan), with confirmation by needle aspiration for bacteriology studies. The therapeutic strategy consists of bactericidal antibiotics, adapted to the germs, sometimes in combination with percutaneous or surgical drainage, and control of the primary source. The presence of bile in the aspirate or drainage fluid attests to communication with the biliary tree and calls for biliary MRI looking for obstruction. When faced with HA, the attending physician should seek advice from a multi-specialty team including an interventional radiologist, a hepatobiliary surgeon and an infectious disease specialist. This should help to determine the origin and mechanisms responsible for the abscess, and to then propose the best appropriate treatment. The presence of chronic enteric biliary contamination (i.e., sphincterotomy, bilio-enterostomy) should be determined before performing radio-frequency ablation and/or chemo-embolization; substantial stenosis of the celiac trunk should be detected before performing pancreatoduodenectomy to help avoid iatrogenic HA.

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Section: Post-transplantation Hepatic Abscessmentioning

confidence: 99%

Hepatic abscess: Diagnosis and management

Lardière-Deguelte

Ragot

Amroun

et al. 2015

Journal of Visceral Surgery

224

247

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“… 2 , 3 , 5 Additionally, complications associated with interventional procedures and surgical techniques have resulted in PLAs. 6 - 8 …”

Section: Discussionmentioning

confidence: 99%

“…2,3,5 Additionally, complications associated with interventional procedures and surgical techniques have resulted in PLAs. [6][7][8] Patients with PLA typically present with fever and abdominal pain. 2,5,9 Other nonspecific symptoms including nausea, vomiting, anorexia, weight loss, and malaise are also common.…”

Section: Discussionmentioning

confidence: 99%

Fever Through a Jaundiced Eye

Kennelly

Petz

Rockey

2014

Journal of Investigative Medicine High Impact Case Reports

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Pyogenic liver abscess (PLA) is an important clinical entity to consider in a patient with fever and abdominal pain. Previously, the condition was difficult to diagnose and treat, but with the introduction of widely available and reliable imaging techniques, its diagnosis has become more straightforward. Although uncommon, PLA should especially be considered in the differential diagnosis for patients with specific predisposing conditions such as underlying biliary tract disease, whether as a result of chronic inflammatory disease or malignancy. The introduction of percutaneous drainage has revolutionized the management of PLA, and thus, this disease has become largely correctable.

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“…Уже на этапе изъя-тия донорского органа ошибки в идентификации артериального кровоснабжения трансплантата могут обернуться непреднамеренной травмой печеночной артерии и ее ветвей [8]. Кроме того, наличие нескольких независимых источников артериального кровоснабжения, как правило, требует выполнения сложных артериальных реконструкций на этапе "back-table", что также является одним из факторов риска артериально-го тромбоза [1,2,5,9].…”

Section: Review Articles and Lecturesunclassified

Vascular complications after orthotopic liver transplantation

Новрузбеков¹,

Олисов²

2017

Transplantologiâ (Mosk.)

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Liver abscess developed after cadaveric liver transplantation due to ligation of an accessory right hepatic artery of the donor graft

Cited by 14 publications

References 9 publications

Hepatic abscess: Diagnosis and management

Hepatic abscess: Diagnosis and management

Fever Through a Jaundiced Eye

Vascular complications after orthotopic liver transplantation

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