Extrahepatic complications of liver transplantation.

The massive surgical assault associated with hepatic transplantation makes a high frequency of complications almost inevitable. In this review of 225 patient records, selected at random from cases of liver transplantation in Pittsburgh over a 2 1/2 year period ending in January 1985, 87.2% of patients experienced at least one significant complication that threatened their survival or that of the graft and that often prolonged their hospitalization. Familiarity with the complications may facilitate earlier recognition, with consequently early and more effective management in future cases

Portal vein grafts in hepatic transplantation

Confirmation of patency of the portal vein by either ultrasound or angiography is a routine part of the evaluation of patients being considered for hepatic transplantation. Complete thrombosis of the portal vein usually has been viewed as precluding successful orthotopic hepatic replacement. In addition, some pediatric patients present with extremely small portal veins which, although patent, have proved to be thick walled and sclerotic. Our recent experience has shown that, in both of these situations, successful and complete revascularization of hepatic allografts is quite feasible by using a vein graft to ensure adequate portal venous flow

A simplified technique for the treatment of simple pleural effusions

This technique for the drainage of simple pleural effusions is simple, safe and effective. It requires little more skill than the ability to perform a thoracentesis or central venous line placement. It appears ideal for both the bedridden patient who cannot sit for repetitive thoracocentesis and for the ambulatory patient who need not be tied down with a chest tube and underwater seal system. We stress that the system is functional only for simple transudates and will provide unsatisfactory drainage of thick or bloody effusions