Vascular complications related to liver transplantation

Pawlak, Jacek; Wróblewski, Tadeusz; Małkowski, Piotr; Nyckowski, P; Zieniewicz, Krzysztof; Grzelak, I; Alsharabi, A.; Michałowicz, B; Krawczyk, Marek; Karwowski, A

doi:10.1016/s0041-1345(00)01281-1

Cited by 23 publications

(22 citation statements)

References 13 publications

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“…Os principais fatores de risco para essa complicação são o pequeno diâmetro dos vasos anastomosados, um tempo de isquemia fria prolongada, incompatibilidade ABO, idade do doador, erros técnicos, episódios de rejeição celular aguda, tipo de anastomose realizada e variações anatômicas 14 . Em uma série brasileira de 169 transplantes, foi encontrada 8,8 % de trombose arterial 15 .…”

Section: Discussionunclassified

Transplante de fígado: resultados iniciais

Garcia

Vasconcelos

Brasi

et al. 2005

Rev. Col. Bras. Cir.

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Section: Discussionunclassified

Transplante de fígado: resultados iniciais

Garcia

Vasconcelos

Brasi

et al. 2005

Rev. Col. Bras. Cir.

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“…The treatment of bile duct stricture following OLT has been transitioned from pure operation to non-operation [8] . Indeed 90% of bile duct obstruction can be improved through balloon expansion, endoprosthesis placement and bile duct drainage [9] .…”

Section: Value Of Interventional Therapy In Non-stoma Bile Duct Stricmentioning

confidence: 99%

Role of interventional therapy in hepatic artery stenosis and non-anastomosis bile duct stricture after orthotopic liver transplantation

Zhao

Song²,

Jiang³

et al. 2007

WJG

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AIM:To analyze the clinical manifestations and the effectiveness of therapy in patients with orthotopic liver transplantation (OLT)-associated hepatic artery stenosis (HAS) and non-anastomosis bile duct stricture. METHODS:Nine cases were diagnosed as HAS and non-anastomosis bile duct stricture. Percutaneous transluminal angioplasty (PTA) was performed in four HAS cases, and expectant treatment in other five HAS cases; percutaneous transhepatic bile drainage, balloon dilation, stent placement were performed in all nine cases. RESULTS:Diffuse intra-and extra-bile duct stricture was observed in nine cases, which was associated with bile mud siltation and biliary infection. Obstruction of the bile duct was improved obviously or removed. Life span/ follow-up period was 13-30 mo after PTA of four HAS cases, 6-23 mo without PTA of other five cases.CONCLUSION: P r o g r e s s i v e , n o n -a n a s t o m o s i s , and diffuse bile duct stricture are the characteristic manifestations of HAS and non-anastomosis bile duct stricture after OLT. These are often associated with bile mud siltation, biliary infection, and ultimate liver failure. Interventional therapy is significantly beneficial.

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“…The mechanism of these hemodynamic changes may be contributed to the follows: (1) When HA supply is decreased because of HA anastomotic stoma edema and reperfusion damage, the PV compensates the liver blood supply by increasing blood flow volume and velocity at early postoperation; (2) For the cirrhosis OLT patients without splenectomy, the PV blood flow is enhanced; (3) The RI of SMA is decreased because of the declined vasodilator materials deactivation in vivo in early stage of posttransplantation, which also induces the increased refluxing blood flow to PV [2,3] .…”

Section: The Mechanism and Clinical Value Of Pv Hemodynamic Changesmentioning

confidence: 99%

Hemodynamic changes on color Doppler flow imaging and intravenous contrast-enhanced ultrasound for assessing transplanted liver and early diagnosis of complications

Dao-zhong

Chen

et al. 2008

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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The value of color Doppler flow imaging (CDFI) and intravenous contrast-enhanced ultrasound (CEUS) for assessing the transplanted liver and early diagnosing complications by examining hemodynamic changes was discussed. Seventy-five patients with orthotopic liver transplantation (OLT) underwent CDFI. The following parameters were measured: peak systolic velocity (PS), resistance index (RI) and Doppler perfusion index (DPI) of the hepatic artery (HA), time average velocity (TAV) of portal vein (PV) and velocity of hepatic vein (HV) in different stages postoperation. And 11 patients of them received CEUS. Thirty healthy subjects were enrolled as controls. The results showed that: (1) In 23 patients without obvious complications, TAV of PV within 15 days post-operation was significantly higher than in controls (P<0.05), PS and DPI of HA within 7 days postoperation were lower, but RI was higher than in controls (P<0.05); (2) When the hepatic artery thrombosis (HAT) occurred, PS and DPI of HA were obviously decreased, but TAV of PV significantly increased like a high saw-tooth wave; (3) While rejection occurred, both TAV of PV and PS of HA were decreased with the increase in RI of HA, and the triphasic wave of HV disappeared and displayed as saw-tooth wave; (4) The incidence of biliary complications in liver transplantation was increased when DPI was reduced; (5) Seven cases of hepatic carcinoma relapse after OLT demonstrated hyperecho in the arterial phase and hypoecho in the portal and later phase on CEUS; (6) In 2 cases of HA thrombus, there was no visualized enhancement in arterial phase of CEUS, but enhancement during the portal vein and parenchymal phase. It was concluded that the hemodynamic changes of PV, HA and HV in the transplanted liver are valuable for assessing the transplanted liver and early diagnosing complications on CDFI and CEUS.

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Vascular complications related to liver transplantation

Cited by 23 publications

References 13 publications

Transplante de fígado: resultados iniciais

Transplante de fígado: resultados iniciais

Role of interventional therapy in hepatic artery stenosis and non-anastomosis bile duct stricture after orthotopic liver transplantation

Hemodynamic changes on color Doppler flow imaging and intravenous contrast-enhanced ultrasound for assessing transplanted liver and early diagnosis of complications

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