Technical considerations in liver transplantation: What a hepatologist needs to know (and every surgeon should practice)

Eghtesad, Bijan; Kadry, Zakiyah; Fung, John J.

doi:10.1002/lt.20529

Cited by 40 publications

(30 citation statements)

References 78 publications

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“…Surgical innovations have been reported for hilum dissection, thrombectomy and portal vein reconstruction using vein grafts in deceased liver transplantation. [1][2][3][4][5][6][7][8][9][10][11][12][13] In living donor liver transplantation (LDLT), there are technical difficulties due to these challenges for preexisting PVT patients; necessity of distal dissection of vascular pedicle of the hilum and restricted availability of a vein graft. The presence of PVT in the recipient has frequently been presented as a relative or absolute contraindication in LDLT by numerous groups.…”

Section: See Editorial On Page 1455mentioning

confidence: 99%

Single center experience of 39 patients with preoperative portal vein thrombosis among 404 adult living donor liver transplantations

et al. 2006

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Living donor liver transplantation (LDLT) for patients with portal vein thrombosis (PVT) involves technical difficulty. The aim of this research was to analyze their preoperative diagnosis of PVT, operative procedures, and postoperative courses of patients with preoperative PVT. Thirty-nine patients of 404 adult patients (9.7%) undergoing LDLT in our hospital from 1996 June to 2004 December had PVT at their transplantation. Twenty-nine patients had intractable ascites, 21 had gastrointestinal bleeding, and 18 had encephalopathy. The thrombus was located in the portal trunk in 23, in the portal trunk and superior mesenteric vein (SMV) in 7, and developed into the SMV and the splenic vein in 8. The occlusive grade was partial in 29, and complete in 10 patients. The thrombus was removed by a simple technique, and eversion and/or incision technique, or total removal of the portal vein (PV). The PV was reconstructed with the thrombectomized native PV, with an interposed vein graft, or porto-caval hemitransposition. Advanced PVT had a significant impact on blood loss and hospital mortality. Three out of 10 patients with residual PVT required radiological and/or surgical intervention after transplantation. In conclusion, thorough planning is essential for a successful LDLT outcome for patients with preexisting PVT. Liver Transpl 12:1512-1518, 2006

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Section: See Editorial On Page 1455mentioning

confidence: 99%

Single center experience of 39 patients with preoperative portal vein thrombosis among 404 adult living donor liver transplantations

et al. 2006

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“…6 Percutaneous transluminal angioplasty may have 90% success for treatment of late hepatic artery thrombosis, but complications may include thrombosis and dissection of the artery. 7 When all other treatment fails and hepatic artery thrombosis recurs, revision liver transplant may be the only effective treatment. 8 In the present case, revision of the anastomosis was successful but stenosis occurred.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Jafarian

Kasraianfard²,

Nassiri-Toosi³

2014

Exp Clin Transplant

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Early hepatic artery thrombosis after liver transplant may be complicated by aggressive aspergillosis and bacterial infections that may cause morbidity and mortality. The definitive treatment of hepatic artery thrombosis is revision transplant. However, sepsis may be a contraindication to revision transplant. A 37-year-old man developed hepatic artery thrombosis at 3 days after liver transplant. During the treatment of hepatic artery thrombosis, he developed multiple biliary, bacterial, and fungal infections. Evaluation showed aspergillosis with multiple intrahepatic abscesses. He was treated with antibiotic and antifungal drugs. Despite active sepsis, revision transplant was performed and the infection resolved. Although sepsis may be a contraindication for transplant surgery, revision transplant was successful, probably because the primary transplanted liver was the source of infection.

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“…Ideally, a surgeon can become familiar with all the techniques in order to adapt to different situations (Eghtesad et al, 2005).…”

Section: Wwwintechopencommentioning

confidence: 99%

Vascular and Biliary Anastomoses in Deceased Donor Orthotopic Liver Transplantation

Raofi¹,

Cohn²,

Koffron³

et al. 2012

Liver Transplantation - Technical Issues and Complications

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Technical considerations in liver transplantation: What a hepatologist needs to know (and every surgeon should practice)

Cited by 40 publications

References 78 publications

Single center experience of 39 patients with preoperative portal vein thrombosis among 404 adult living donor liver transplantations

Single center experience of 39 patients with preoperative portal vein thrombosis among 404 adult living donor liver transplantations

Untitled

Vascular and Biliary Anastomoses in Deceased Donor Orthotopic Liver Transplantation

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