The devil is in the detail: current management of perioperative surgical complications after liver transplantation

Patel, Priyal V.; DiNorcia, Joseph

doi:10.1097/mot.0000000000000616

Cited by 4 publications

(2 citation statements)

References 51 publications

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“…Orthotopic liver transplantation remains the only potentially curative method to treat a variety of end-stage liver diseases while extending life expectancy in this patient cohort [1,2]. However, postoperative complications frequently occur and a mortality rate of 11% within the first six months after transplantation is reported for patients undergoing OLT [3,4]. Specifically, early allograft dysfunction (EAD) as a non-surgical complication occurs in 15-30% of all patients after OLT [5].…”

Section: Introductionmentioning

confidence: 99%

Characterization of Perioperative Serotonin in Patients Undergoing Orthotopic Liver Transplantation

Zott,

Pereyra,

Kersten

et al. 2024

JCM

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Background: Platelets were shown to be relevant for liver regeneration. In particular, platelet-stored serotonin (5-HT) proved to be a pro-regenerative factor in this process. The present study aimed to investigate the perioperative course of 5-HT and evaluate associations with patient and graft outcomes after othotopic liver transplantation (OLT). Methods: 5-HT was quantified in plasma and serum of 44 OLT recipients perioperatively, and in their respective donors. Olthoff’s criteria for early allograft dysfunction (EAD) were used to evaluate postoperative outcomes. Results: Patients with higher donor intra-platelet 5-HT per platelet (IP 5-HT PP) values had significantly lower postoperative transaminases (ASAT POD1: p = 0.006, ASAT POD5: p = 0.006, ASAT POD10: p = 0.02, ALAT POD1: p = 0.034, ALAT POD5: p = 0.017, ALAT POD10: p = 0.04). No significant differences were seen between postoperative 5-HT values and the occurrence of EAD. A tendency was measured that donor IP 5-HT PP is lower in donor-recipient pairs that developed EAD (p = 0.07). Conclusions: Donor IP 5-HT PP might be linked to the postoperative development of EAD after OLT, as higher donor levels are correlated with a more favorable postoperative course of transaminases. Further studies with larger cohorts are needed to validate these findings.

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Section: Introductionmentioning

confidence: 99%

Characterization of Perioperative Serotonin in Patients Undergoing Orthotopic Liver Transplantation

Zott,

Pereyra,

Kersten

et al. 2024

JCM

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“…B iliary complications remain the most common complication after liver transplantation, affecting up to 1 quarter of recipients. [1][2][3][4] Biliary complications are typically managed endoscopically and, in some cases, percutaneously with a high success rate (70-100%). [5][6][7] Surgery is reserved for cases when endoscopic and percutaneous methods fail.…”

mentioning

confidence: 99%

Robotic Hepaticojejunostomy for Late Anastomotic Biliary Stricture After Liver Transplantation

et al. 2021

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Biliary strictures after liver transplantation are common and when refractive to endoscopic and percutaneous intervention require surgical revision. Robotic technology facilitates minimally invasive biliary reconstruction and has not previously been described after liver transplantation. Robotic biliary revisions were retrospectively compared to all the historical open cases over a time period from May 2013 to October 2020. During the study period there were 3 robotic and 4 open surgical biliary revisions with a follow-up of at least 6months. All cases were hepaticojejunostomies for late choledochocholedochostomy anastomotic strictures presenting > 4 weeks after transplant and refractive to at least 3 endoscopic and/or percutaneous interventions. Median(range) case time was longer in the robotic group, 373 minutes (286-373) compared to open group, 280 minutes (163-321). The median length of stay was shorter in the robotic group, 4 days (1--4) compared to open group 7 days (4-10). Morbidity included 2 wound infections in the open group (grade II), 1 infected hematoma in the robotic group (grade Ilia), and 1 bile leak on the open group (grade Ilia). There was no biliary stricture recurrence or mortality in either group. Robotic biliary revision is a safe alternative to traditional open biliary revision for refractive biliary strictures after liver transplantation.

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Liver disease in infants and children

DiNorcia,

Bucuvalas,

Batsis

et al. 2025

Hepatology

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The devil is in the detail: current management of perioperative surgical complications after liver transplantation

Cited by 4 publications

References 51 publications

Characterization of Perioperative Serotonin in Patients Undergoing Orthotopic Liver Transplantation

Characterization of Perioperative Serotonin in Patients Undergoing Orthotopic Liver Transplantation

Robotic Hepaticojejunostomy for Late Anastomotic Biliary Stricture After Liver Transplantation

Liver disease in infants and children

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