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Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report
OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can’t be performed but the donor may be not available in the short period of ti...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994732/ https://www.ncbi.nlm.nih.gov/pubmed/29751198 http://dx.doi.org/10.1016/j.ijscr.2018.04.029 |
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author | Lapisatepun, Worakitti Chotirosniramit, Anon Sandhu, Trichak Udomsin, Kanya Ko-iam, Wasana Chanthima, Phuriphong Lapisatepun, Warangkana Boonsri, Settapong Lorsomradee, Suraphong Kaewpoowat, Quanhathai Junrungsee, Sunhawit |
author_facet | Lapisatepun, Worakitti Chotirosniramit, Anon Sandhu, Trichak Udomsin, Kanya Ko-iam, Wasana Chanthima, Phuriphong Lapisatepun, Warangkana Boonsri, Settapong Lorsomradee, Suraphong Kaewpoowat, Quanhathai Junrungsee, Sunhawit |
author_sort | Lapisatepun, Worakitti |
collection | PubMed |
description | OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can’t be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son. Post operative day 41, HAT was diagnosed from angiogram and liver function got rapidly worse. We decided to re-anastomose the hepatic artery but this was not possible due to a thrombosis in the distal right hepatic artery. So PVA by anastomosis of the common hepatic artery to splenic vein was performed. During the early postoperative period liver function gradually improved. Unfortunately, he died from massive GI hemorrhage one month later. DISCUSSION: PVA has previously been reported as being useful when revascularization was not successful. The surgical technique is not complicated and can be performed in sick patient. Liver graft may be salvaged with oxygenated portal flow and recover afterwards. However, portal hypertension after PVA seem to be an inevitable complication. CONCLUSIONS: PVA may be a bridging treatment for retransplantation in patients whom hepatic artery reconstruction is impossible after HAT. Regards to the high morbidity after procedure, retransplantation should be performed as definite treatment as soon as possible. |
format | Online Article Text |
id | pubmed-5994732 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-59947322018-06-12 Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report Lapisatepun, Worakitti Chotirosniramit, Anon Sandhu, Trichak Udomsin, Kanya Ko-iam, Wasana Chanthima, Phuriphong Lapisatepun, Warangkana Boonsri, Settapong Lorsomradee, Suraphong Kaewpoowat, Quanhathai Junrungsee, Sunhawit Int J Surg Case Rep Article OBJECTIVE: Hepatic artery thrombosis (HAT) is one of the most serious complications of liver transplantation that can potentially lead to loss of the allograft. Retransplantation is the only option when revascularization can’t be performed but the donor may be not available in the short period of time. We report the technique of using portal vein arterialization (PVA) for bridging before retransplantation. There are few reports in living donor setting. CASE DESCRIPTION: The recipient of the liver was a 59 year old male who received an extended right lobe graft from his son. Post operative day 41, HAT was diagnosed from angiogram and liver function got rapidly worse. We decided to re-anastomose the hepatic artery but this was not possible due to a thrombosis in the distal right hepatic artery. So PVA by anastomosis of the common hepatic artery to splenic vein was performed. During the early postoperative period liver function gradually improved. Unfortunately, he died from massive GI hemorrhage one month later. DISCUSSION: PVA has previously been reported as being useful when revascularization was not successful. The surgical technique is not complicated and can be performed in sick patient. Liver graft may be salvaged with oxygenated portal flow and recover afterwards. However, portal hypertension after PVA seem to be an inevitable complication. CONCLUSIONS: PVA may be a bridging treatment for retransplantation in patients whom hepatic artery reconstruction is impossible after HAT. Regards to the high morbidity after procedure, retransplantation should be performed as definite treatment as soon as possible. Elsevier 2018-05-02 /pmc/articles/PMC5994732/ /pubmed/29751198 http://dx.doi.org/10.1016/j.ijscr.2018.04.029 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Lapisatepun, Worakitti Chotirosniramit, Anon Sandhu, Trichak Udomsin, Kanya Ko-iam, Wasana Chanthima, Phuriphong Lapisatepun, Warangkana Boonsri, Settapong Lorsomradee, Suraphong Kaewpoowat, Quanhathai Junrungsee, Sunhawit Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report |
title | Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report |
title_full | Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report |
title_fullStr | Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report |
title_full_unstemmed | Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report |
title_short | Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report |
title_sort | price to pay; portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; a case report |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994732/ https://www.ncbi.nlm.nih.gov/pubmed/29751198 http://dx.doi.org/10.1016/j.ijscr.2018.04.029 |
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