Excision and immediate revascularization for hepatic artery pseudoaneurysm following liver transplantation

Bonham, Clark A.; Kapur, Sandip; Geller, David A.; Fung, John J.; Pinna, A

doi:10.1016/s0041-1345(98)01698-4

Cited by 34 publications

(24 citation statements)

References 5 publications

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“…We recommend this type of arterial anastomosis as an excellent method, especially in patients with splenomegaly due to their larger splenic artery. [14][15][16] In addition, this method can result in earlier normalization of platelet counts. 1,17,18 …”

Section: Discussionmentioning

confidence: 99%

Untitled

Kazemi

Samidoost²,

Deilami³

et al. 2017

Exp Clin Transplant

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Objectives: In some cases of liver transplant, standard hepatic artery reconstruction may be difficult or impossible due to inadequate flow of the recipient's hepatic artery, as a result of stenosis, intimal dissection, or anomalies of the hepatic artery. We compared splenic artery transposition with extraanatomic jump graft as 2 alternative methods for hepatic artery reconstruction in these situations.

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Section: Discussionmentioning

confidence: 99%

Untitled

Kazemi

Samidoost²,

Deilami³

et al. 2017

Exp Clin Transplant

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“…Arterial reconstruction at this stage may be less critical for long-term graft survival because of the development of collaterals (5), but revascularization is still preferred. The etiology of a late HAA is less likely to be infectious (2), which further supports attempts at arterial reconstruction. The HAAs presenting late after OLT, even if not infected, are likely to be large enough to preclude primary anastomosis after aneurysmectomy, thus requiring interposition of a vascular conduit.…”

mentioning

confidence: 81%

“…Its discovery may result from an evaluation of abdominal symptoms (patient 1), or it may be serendipitous (patient 2). Earlier presentations may be serendipitous as well (10,12), but also include fever (12); upper gastrointestinal hemorrhage (hemobilia or arterio-gastric/enteric fistula) (1,2,10,11,13,14); and intra-abdominal hemorrhage (1,2,4,6). The etiology of HAAs is less likely to be infectious in aneu-rysms discovered more than 2 months after transplantation (2), although it is possible they originate from an infectious cause which is subsequently cleared or that the intraoperative cultures are falsely negative.…”

Section: Vascular Homograft Use In Liver Transplantationmentioning

confidence: 99%

“…A successful outcome following aneurysmectomy is more likely if the liver can be revascularized (2). Potential surgical options to achieve revascularization include primary re-anastomosis after aneurysmectomy, which is not likely feasible with late HAAs, or the use of a vascular conduit.…”

Section: Vascular Homograft Use In Liver Transplantationmentioning

confidence: 99%

“…comorbidity and therefore have a high mortality (1,2). Early HAAs frequently have an infectious etiology, and ligation is often viewed as the only viable surgical option at this stage.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Use of Preserved Vascular Homografts in Liver Transplantation: Hepatic Artery Aneurysms and Other Complications

Sellers¹,

Haustein²,

McGuire

et al. 2002

American Journal of Transplantation

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Hepatic artery aneurysms/pseudoaneurysms (HAAs) are rare but serious complications after orthotopic liver transplantation (OLT). Revascularization should accompany aneurysmectomy if possible and is more feasible if the aneurysm presents late after transplantation. The optimal conduits for revascularization in this situation are not known. Two patients with hepatic artery aneurysms/pseudoaneurysms who had aneurysmectomy and revascularization with thirdparty cadaveric iliac arterial grafts 1 and 4 years after OLT are presented in detail, with an emphasis on the preservation method used for the grafts. Both livers were successfully revascularized with arterial grafts preserved for 21 and 26 days after procurement. Hepatic patency was documented in both 5 and 6 months after repair; graft function has remained normal 13 and 32 months after repair. Third-party vessels preserved for shorter periods have been used successfully in four other situations, including living-donor liver transplantation, and are briefly discussed. In conclusion, properly preserved vascular homografts are useful in LT for purposes other than initial vascular reconstruction. They also provide an excellent vascular conduit in recipients of livers from other (possibly living) donors.

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