OBJECTIVES: Adequate hepatic arterial (HA) flow to the bile duct is essential in liver transplantation. This study was conducted to determine if the ratio of directly measured HA flow to weight is related to the occurrence of biliary complications after deceased donor liver transplantation. METHODS: A retrospective review of 2684 liver transplants carried out over a 25-year period was performed using data sourced from a prospectively maintained database. Rates of biliary complications (biliary leaks, anastomotic and non-anastomotic strictures) were compared between two groups of patients with HA flow by body weight of, respectively, <5 ml/min/kg (n = 884) and ≥5 ml/min/kg (n = 1800). RESULTS: Patients with a lower ratio of HA flow to weight had higher body weight (92 kg versus 76 kg; P < 0.001) and lower HA flow (350 ml/min versus 550 ml/min; P < 0.001). A lower ratio of HA flow to weight was associated with higher rates of biliary complications at 2 months, 6 months and 12 months (19.8%, 28.2% and 31.9% versus 14.8%, 22.4% and 25.8%, respectively; P < 0.001). CONCLUSIONS: A ratio of HA flow to weight of < 5 ml/min/kg is associated with higher rates of biliary complications. This ratio may be a useful parameter for application in the prevention and early detection of biliary complications.
OBJECTIVES: Adequate hepatic arterial (HA) flow to the bile duct is essential in liver transplantation. This study was conducted to determine if the ratio of directly measured HA flow to weight is related to the occurrence of biliary complications after deceased donor liver transplantation. METHODS: A retrospective review of 2684 liver transplants carried out over a 25-year period was performed using data sourced from a prospectively maintained database. Rates of biliary complications (biliary leaks, anastomotic and non-anastomotic strictures) were compared between two groups of patients with HA flow by body weight of, respectively, <5 ml/min/kg (n = 884) and ≥5 ml/min/kg (n = 1800). RESULTS:Patients with a lower ratio of HA flow to weight had higher body weight (92 kg versus 76 kg; P < 0.001) and lower HA flow (350 ml/min versus 550 ml/min; P < 0.001). A lower ratio of HA flow to weight was associated with higher rates of biliary complications at 2 months, 6 months and 12 months (19.8%, 28.2% and 31.9% versus 14.8%, 22.4% and 25.8%, respectively; P < 0.001). CONCLUSIONS: A ratio of HA flow to weight of < 5 ml/min/kg is associated with higher rates of biliary complications. This ratio may be a useful parameter for application in the prevention and early detection of biliary complications.
Authors: Koji Hashimoto; Charles M Miller; Cristiano Quintini; Federico N Aucejo; Kenzo Hirose; Teresa Diago Uso; Loris Trenti; Dympna M Kelly; Charles G Winans; David P Vogt; Bijan Eghtesad; John J Fung Journal: Surgery Date: 2010-03-15 Impact factor: 3.982
Authors: Sanjeet Thethy; Benjamin Nj Thomson; Henry Pleass; Stephen J Wigmore; Krishnakumar Madhavan; Murat Akyol; John Lr Forsythe; O James Garden Journal: Clin Transplant Date: 2004-12 Impact factor: 2.863
Authors: S Francque; A Verrijken; I Mertens; G Hubens; E Van Marck; P Pelckmans; P Michielsen; L Van Gaal Journal: Int J Obes (Lond) Date: 2010-07-27 Impact factor: 5.095
Authors: Sven Francque; Sam Wamutu; Shyama Chatterjee; Eric Van Marck; Arnold Herman; Albert Ramon; Alexander Jung; Wim Vermeulen; Benedicte De Winter; Paul Pelckmans; Peter Michielsen Journal: Liver Int Date: 2009-10-13 Impact factor: 5.828