Vascular complications after orthotopic liver transplantation

Alan Norman Langnas, Wagner Marujo, Robert J. Stratta, R. Patrick Wood, Byers W. Shaw

Research output: Contribution to journalArticle

381 Citations (Scopus)

Abstract

Over a 57-month period, we performed 430 orthotopic liver transplants in 372 patients. A total of 38 vascular complications were identified including hepatic artery thrombosis (n = 24), portal vein thrombosis (n = 6), combined hepatic artery thrombosis/portal vein thrombosis (n = 3), and hepatic artery rupture (n = 5). A number of potential risk factors for the development of vascular thrombosis were evaluated with only children, weight less than 10 kg, and cold ischemia time found to be significant. The clinical presentation included fulminant hepatic failure, allograft dysfunction, biliary sepsis, and screening ultrasound. Duplex ultrasonography was diagnostic in nearly all cases. Therapeutic modalities included revascularization, revascularization followed by retransplantation, retransplantation alone, and observation. Five cases of hepatic artery rupture occurred in four patients. Infectious arteritis was present in four patients. The 6-month actuarial survival in patients with vascular complications was 70%. Early diagnosis is critical for graft salvage, with surgical intervention the mainstay of therapy.

Original languageEnglish (US)
Pages (from-to)76-83
Number of pages8
JournalThe American Journal of Surgery
Volume161
Issue number1
DOIs
StatePublished - Jan 1 1991

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Liver Transplantation
Hepatic Artery
Blood Vessels
Thrombosis
Portal Vein
Rupture
Transplants
Cold Ischemia
Arteritis
Acute Liver Failure
Only Child
Allografts
Early Diagnosis
Ultrasonography
Sepsis
Observation
Weights and Measures
Survival
Liver
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Vascular complications after orthotopic liver transplantation. / Langnas, Alan Norman; Marujo, Wagner; Stratta, Robert J.; Wood, R. Patrick; Shaw, Byers W.

In: The American Journal of Surgery, Vol. 161, No. 1, 01.01.1991, p. 76-83.

Research output: Contribution to journalArticle

Langnas, Alan Norman ; Marujo, Wagner ; Stratta, Robert J. ; Wood, R. Patrick ; Shaw, Byers W. / Vascular complications after orthotopic liver transplantation. In: The American Journal of Surgery. 1991 ; Vol. 161, No. 1. pp. 76-83.
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