Hepatic Artery Thrombosis in Liver Transplantation - Case Report and Literature Review

Q4 Medicine

Surgery, Gastroenterology and Oncology Pub Date : 2021-06-30 DOI:10.21614/sgo-26-2-356

C. Picu, F. Botea, D. Hrehoreţ, S. Alexandrescu, R. Grigorie, V. Brașoveanu

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引用次数: 0

Abstract

We present a case of a 63-year-old male with HCC developed on viral cirrhosis (HVB-HVD) Child C, MELD 15 who was performed a cadaveric orthotopic liver transplantation (marginal graft previous perfused and oxygenated using the Liver Assist Device). After one month, in the context of a febrile episode, the patient was discovered a biliary stenosis associated with biliary fistulae for which he was placed a biliary stent (ERCP). The afterwards abdominal CT revealed absence of the visualization of the graft common hepatic artery and its intrahepatic branches. An arteriography in an emergency manner was performed, with administration of Actylise, and then continued with Ilomedin and Heparin administration, but with no improved imaging appearance. The patient underwent a liver retransplantation - the arterial anastomose was performed between the donor superior mesenteric artery (due to the anatomical variant: accessory right hepatic artery from superior mesenteric artery) and the recipient infrarenal aorta (using iliac cadaveric arterial graft). 18 months after the retransplantation, the CT scan revealed homogeneous hepatic graft and permeable vascular axis.

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肝移植并发肝动脉血栓1例并文献复习

我们报告一例63岁男性HCC并发病毒性肝硬化(HVB-HVD)， Child C, MELD 15，行尸体原位肝移植(边缘移植物先前使用肝辅助装置灌注和充氧)。1个月后，患者发热发作，发现胆道狭窄伴胆道瘘，并放置胆道支架(ERCP)。术后腹部CT显示移植肝总动脉及其肝内分支不见。在紧急情况下进行动脉造影，并给予actilise，然后继续给予伊洛美丁和肝素，但没有改善影像学表现。患者行肝脏再移植手术，在供体肠系膜上动脉(由于解剖变异:右肝副动脉来自肠系膜上动脉)与受体肾下主动脉(髂尸动脉移植)之间进行动脉吻合。再移植18个月后，CT扫描显示肝移植物均质，血管轴通透。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery, Gastroenterology and Oncology Medicine-Gastroenterology

CiteScore

0.30

自引率

0.00%

发文量

期刊介绍： Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.