24 research outputs found
EFFECTS OF THE TRANS-ARTERIAL CHEMOEMBOLIZATION ON HEPATIC ARTERY COMPLICATIONS IN PATIENTS UNDERWENT LIVER TRANSPLANTATION
Analysis of risk factors for postoperative bile leaks after 411 consecutive hepatectomies
HEPATIC ARTERY KINKING DURING LIVER TRANSPLANTATION: SURVEY AND INTRAOPERATIVE FLOW MEASUREMENT
Fluindione: a francophone oral anticoagulant drug utilized in liver transplant recipients for Budd-Chiari syndrome
Hepatic Artery Kinking during Liver Transplantation: Survey and Intraoperative Flow Measurement
Autologous Saphenous By-Pass as Treatement of the Hepatic Artery Pseudoaneurym in Liver Transplant Recipients
Hepatic Artery Kinking during Liver Transplantation Survey and Prospective Intraoperative Flow Measurement
Hepatic artery thrombosis (HAT) represents the most common vascular complication occurring after liver transplantation (LT). Herein, we report the results of a prospective study of hepatic artery flow (HAF) measurement during abdominal wall closure after LT along with the results of an international survey of procedures adopted, in order to avoid the arterial kinking (AK) in case of long artery. Sixty-four surgeons were asked regarding the different procedures used to avoid AK in the presence of long artery. We prospectively assessed the HAF during three phases of LT in 26 consecutive LT performed in patients with a long HA: after completion of the biliary anastomosis (M0), and partial abdominal wall closure with (M1w) or without (M1w/o) hepatic artery anti-kinking method (HAAK). Sixty (93.7 %) surgeons replied to the survey: 44 (73.3 %) surgeons cut the artery as short as possible, of whom 38 (86.3 %) interposed an oxidized polymer or the omentum, and six (13.7 %) used other systems. Fourteen (23.3 %) surgeons did not use any interposition methods. The remaining two (3.3 %) surgeons left a long artery without HAAK. In our cohort we obtained the following HAF measures: M0 152 mL/min (89-205), M1 without HAAK 114 (66-168) and M1 with HAAK procedure 158 (91-219) (p = 0.002). Our survey confirms that no consensus is currently available regarding the most effective method for avoiding AK. Kinking occurs most probably when the liver is released in its final position. The utilization of an interposition method could ensure the maintenance of a correct HAF