Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report

© 2018 The Authors 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 i...

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Main Authors: Worakitti Lapisatepun, Anon Chotirosniramit, Trichak Sandhu, Kanya Udomsin, Wasana Ko-iam, Phuriphong Chanthima, Warangkana Lapisatepun, Settapong Boonsri, Suraphong Lorsomradee, Quanhathai Kaewpoowat, Sunhawit Junrungsee
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/59014
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-590142018-09-05T04:36:24Z Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report Worakitti Lapisatepun Anon Chotirosniramit Trichak Sandhu Kanya Udomsin Wasana Ko-iam Phuriphong Chanthima Warangkana Lapisatepun Settapong Boonsri Suraphong Lorsomradee Quanhathai Kaewpoowat Sunhawit Junrungsee Medicine © 2018 The Authors 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. 2018-09-05T04:36:24Z 2018-09-05T04:36:24Z 2018-01-01 Journal 22102612 2-s2.0-85046673465 10.1016/j.ijscr.2018.04.029 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046673465&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/59014
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Worakitti Lapisatepun
Anon Chotirosniramit
Trichak Sandhu
Kanya Udomsin
Wasana Ko-iam
Phuriphong Chanthima
Warangkana Lapisatepun
Settapong Boonsri
Suraphong Lorsomradee
Quanhathai Kaewpoowat
Sunhawit Junrungsee
Price to pay; Portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; A case report
description © 2018 The Authors 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 Journal
author Worakitti Lapisatepun
Anon Chotirosniramit
Trichak Sandhu
Kanya Udomsin
Wasana Ko-iam
Phuriphong Chanthima
Warangkana Lapisatepun
Settapong Boonsri
Suraphong Lorsomradee
Quanhathai Kaewpoowat
Sunhawit Junrungsee
author_facet Worakitti Lapisatepun
Anon Chotirosniramit
Trichak Sandhu
Kanya Udomsin
Wasana Ko-iam
Phuriphong Chanthima
Warangkana Lapisatepun
Settapong Boonsri
Suraphong Lorsomradee
Quanhathai Kaewpoowat
Sunhawit Junrungsee
author_sort Worakitti Lapisatepun
title 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_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_sort price to pay; portal vein arterialization for hepatic artery thrombosis after living donor liver transplantation; a case report
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046673465&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/59014
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