Surgical complications of liver transplantation

Tan-Tam, Clara; Segedi, Maja; Buczkowski, Andrzej K.; Hussaini, Trana; Yoshida, Eric M.; Chung, Stephen W.; Scudamore, Charles H.

doi:10.21037/amj.2018.10.02

Cited by 3 publications

(3 citation statements)

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“…LTx outcomes have been improving with the advances in the liver transplant field [12], but clinicians encounter frequent posttransplant-related GI problems and complications [4]. Many studies have focused on complications of surgical [13], biliary [7], infectious [11], and vascular diseases [14], but we examined the role and yield of EGD for non-biliary GI complications.…”

Section: Discussionmentioning

confidence: 99%

The Utilization and Diagnostic Yield of Upper Endoscopy for Evaluation of Gastrointestinal Symptoms Within the First Year After Liver Transplantation

Daglilar

Connolly

Tahan

et al. 2020

Cureus

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BackgroundGastrointestinal (GI) symptoms impact quality of life and increase health care utilization after liver transplantation (LTx). Esophagogastroduodenoscopy (EGD) is commonly used to investigate these symptoms. AimsThe aim of this study was to investigate the diagnostic yield and utilization of EGD after LTx for common GI symptoms. MethodsThis single-center retrospective cohort study was conducted at a large liver transplant center and included all adults who underwent EGD within the first year after receiving LTx between January 1, 2015, and December 31, 2016. Biliary procedures were excluded. ResultsOf 437 patients who underwent LTx during the study period, 64 (15%) underwent EGD for the evaluation of GI symptoms within the first year of transplantation. After applying exclusion criteria, 57 (13%) cases were analyzed. GI hemorrhage (hematemesis/melena) was the most common reason (4%; n=18) for evaluation with EGD followed by nausea/anorexia (3%; n=12). Symptoms were investigated with EGD, including epigastric/abdominal pain (2%; n=9), dysphagia/odynophagia (2%; n=8), anemia (1%; n=5), diarrhea (1%; n=4), and heartburn (0.2%; n=1). The diagnostic yield of EGD was highest with GI hemorrhage (83%) followed by dysphagia/odynophagia (75%). EGD diagnostic yield was lower for the other symptoms, ranging from 0% to 25%. ConclusionsEGD was commonly utilized within the first year of LTx, with the highest diagnostic yields for GI hemorrhage and dysphagia/odynophagia. Because of the low diagnostic yield of EGD for other symptoms, we recommend a careful selection of patients for EGD following LTx.

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Section: Discussionmentioning

confidence: 99%

The Utilization and Diagnostic Yield of Upper Endoscopy for Evaluation of Gastrointestinal Symptoms Within the First Year After Liver Transplantation

Daglilar

Connolly

Tahan

et al. 2020

Cureus

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“…Случай интересен также тем, что посттрансплантационный период осложнился целым рядом «больших» жизнеугрожающих осложнений, каждое из которых могло привести к гибели пациентки. У нее последовательно развились наиболее грозные осложнения раннего посттрансплантационного периода, такие как ПНФТ (потребовавший реТП), ТПА (потребовавший эндоваскулярной тромбэкстракции и стентирования ПА), кро- [10][11][12][13].…”

Section: Case Reportsunclassified

Seronegative fibrosing cholestatic hepatitis С after liver retransplantation for unresectable neuroendocrine tumor liver metastases

Восканян

Сюткин²,

Шабалин

et al. 2020

Transplantologiâ (Mosk.)

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We present an uncommon case of liver graft dysfunction caused by seronegative hepatitis C-related fibrosing cholestatic hepatitis after cadaver liver transplantation for unresectable liver metastases of neuroendocrine small intestine cancer followed by living relation donor liver fragment retransplantation for primary graft nonfunction. Early postoperative period was complicated by hepatic artery thrombosis, cerebral hemorrhage, acute cellular rejection, bilateral polysegmental pneumonia, bleeding into neck soft tissues, severe surgical site infection, and sepsis. Anticoagulant therapy, as well as the absence of Hepatitis C Virus antibodies made difficult early diagnostics of fibrosing cholestatic hepatitis. A present-day antiviral therapy produced a complete clinical and virological response. At control examination performed at 240 days after surgery, there were neither signs of cancer progression no graft dysfunction. Liver transplantation in that case was an example of radical and effective treatment method for unresectable liver metastases of neuroendocrine small intestine cancer. Timely diagnosis and proper treatment of fibrosing cholestatic hepatitis made it possible to save the liver graft and patient's life.

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“…Treatment can be determined by the severity of each case and its spectrum includes simple surgical interventions, or even re-transplantation. The main complications are illustrated in Tables 3 and 4 along with diagnostic and therapeutic approaches [108,109].…”

Section: Author Detailsmentioning

confidence: 99%

Management of Patients with Liver Transplantation in ICU

Karapanagiotou¹,

Pitsoulis²,

Vasileiou³

et al. 2019

Liver Disease and Surgery [Working Title]

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Liver transplantation constitutes the most effective and indispensable treatment of end-stage liver disease (ESLD). Major advances in surgical techniques, anesthesiological management, postoperative care, immunosuppression, and diagnostic approach have led to increased overall survival of patients. Postoperative care poses a great challenge since detrimental occurrences that need prompt treatment may affect the graft or distant organ functionality. Adequate graft function is strongly associated with distant organ restoration and rapid patient recovery. In the ICU setting, the main focal points are hemodynamic stabilization, coagulation and electrolyte disturbances correction, respiratory support, early weaning from mechanical ventilation, and evaluation of graft functionality. It is of paramount importance to facilitate early graft recovery, recognize and promptly treat systematic complications and life-threatening sequelae, and individualize treatment protocols considering graft quality, donor's and recipient's health status, and potential co-morbidities. To achieve those goals, technological advancements in continuous patient monitoring, graft functionality, and its metabolic reserves must be assimilated and implemented in the ICU.

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Surgical complications of liver transplantation

Cited by 3 publications

References 0 publications

The Utilization and Diagnostic Yield of Upper Endoscopy for Evaluation of Gastrointestinal Symptoms Within the First Year After Liver Transplantation

The Utilization and Diagnostic Yield of Upper Endoscopy for Evaluation of Gastrointestinal Symptoms Within the First Year After Liver Transplantation

Seronegative fibrosing cholestatic hepatitis С after liver retransplantation for unresectable neuroendocrine tumor liver metastases

Management of Patients with Liver Transplantation in ICU

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