BACKGROUND: From September 1988 through April 1998, 1000 liver transplantations were performed on 911 patients. The standard technique for liver re-vascularization to guarantee an optimal blood inflow during transplantation was modified in 19% of the cases on the arterial side and in 5.6% of the cases on the portal side as a result of unusual anatomical features and pathological changes in the vasculature of the organ recipient. In 113 transplantations, successful reconstruction of accessory vessels of the graft (12 left and 101 right hepatic arteries) was performed without complications. It is our opinion that preoperative diagnosis of the vasculature (stenoses of the celiac trunk etc.) of the organ recipient by duplexsonography and angiography is necessary. Even with the help of these tests, it is extremely difficult to diagnose a "steal" syndrome in the splenic artery: for example, 31 of 40 patients with poor liver function received postoperative therapy for newly diagnosed "steals". RESULTS AND CONCLUSIONS: There is no increase in complications (stenosis and thrombosis) with modifications of arterial reconstruction (4.9 vs 6.3%); however, with modification of portal reconstruction the increase is from 2.4% to 8.3%.
BACKGROUND: From September 1988 through April 1998, 1000 liver transplantations were performed on 911 patients. The standard technique for liver re-vascularization to guarantee an optimal blood inflow during transplantation was modified in 19% of the cases on the arterial side and in 5.6% of the cases on the portal side as a result of unusual anatomical features and pathological changes in the vasculature of the organ recipient. In 113 transplantations, successful reconstruction of accessory vessels of the graft (12 left and 101 right hepatic arteries) was performed without complications. It is our opinion that preoperative diagnosis of the vasculature (stenoses of the celiac trunk etc.) of the organ recipient by duplexsonography and angiography is necessary. Even with the help of these tests, it is extremely difficult to diagnose a "steal" syndrome in the splenic artery: for example, 31 of 40 patients with poor liver function received postoperative therapy for newly diagnosed "steals". RESULTS AND CONCLUSIONS: There is no increase in complications (stenosis and thrombosis) with modifications of arterial reconstruction (4.9 vs 6.3%); however, with modification of portal reconstruction the increase is from 2.4% to 8.3%.
Authors: Siraj Saadaldin Abdullah; Jean-Yves Mabrut; Vincent Garbit; Eric De La Roche; Eric Olagne; Agnès Rode; André Morin; Yves Berthezene; Jacques Baulieux; Christian Ducerf Journal: Surg Radiol Anat Date: 2006-04-27 Impact factor: 1.246
Authors: Roberto Troisi; Guy Cammu; Giuseppe Militerno; Luc De Baerdemaeker; Johan Decruyenaere; Eric Hoste; Peter Smeets; Isabelle Colle; Hans Van Vlierberghe; Mirko Petrovic; Dirk Voet; Eric Mortier; Uwe J Hesse; Bernard de Hemptinne Journal: Ann Surg Date: 2003-03 Impact factor: 12.969
Authors: Sascha A Müller; Bruno M Schmied; Arianeb Mehrabi; Thilo Welsch; Peter Schemmer; Ulf Hinz; Jürgen Weitz; Jens Werner; Markus W Büchler; Jan Schmidt Journal: J Gastrointest Surg Date: 2008-11-26 Impact factor: 3.452