Assessing the Safety of Expanded Polytetrafluoroethylene Synthetic Grafts in Living Donor Liver Transplantation: Graft Migration Into Hollow Viscous Organs – Diagnosis and Treatment Options
| Autor: | Horng Ren Yang, Ashok Thorat, Ping Chun Li, Kin Shing Poon, Long Bin Jeng, Te Hung Chen, Chun Chieh Yeh, Shih Chao Hsu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Peritonitis 030230 surgery Liver transplantation Sepsis Young Adult 03 medical and health sciences 0302 clinical medicine Clinical Research Living Donors medicine Humans Vein Polytetrafluoroethylene Duodenal Perforation Aged medicine.diagnostic_test business.industry Angiography Endoscopy General Medicine Middle Aged medicine.disease Thrombosis Liver Transplantation Surgery medicine.anatomical_structure Female 030211 gastroenterology & hepatology Tomography X-Ray Computed business Spleen |
| Zdroj: | Medical Science Monitor : International Medical Journal of Experimental and Clinical Research |
| ISSN: | 1643-3750 |
| DOI: | 10.12659/msm.902636 |
| Popis: | BACKGROUND Our recent studies have highlighted the importance and safety of backtable venoplasty for middle hepatic vein (MHV) and inferior right hepatic veins (IRHV) reconstruction using expanded polytetrafluoroethylene (ePTFE) vascular grafts. In this study, we aim to analyze the complications associated with ePTFE graft use and discuss the management of the rare, but, potentially life threatening complications directly related to ePTFE conduits. MATERIAL AND METHODS From January 2012 to October 2015 a total of 397 patients underwent living donor liver transplantation (LDLT). The ePTFE vascular grafts were used during the backtable venoplasty for outflow reconstruction in 262 of the liver allografts. Recipients who developed ePTFE-related complications were analyzed. RESULTS ePTFE-related complications developed in 1.52% (4/262) of the patients. One patient (0.38%) developed complete thrombosis with sepsis at 24 months post-transplantation and died due to multiorgan failure. Three patients (1.1%) developed graft migration into the second portion of the duodenum, without overt peritonitis. Surgical exploration and ePTFE graft removal was done in all the patients. One patient died due to overwhelming sepsis. CONCLUSIONS ePTFE graft migration into the duodenum causing perforation is a new set of complications that has been recently described in LDLT and can be treated effectively by surgical removal of the infected vascular graft and duodenal perforation closure. Despite of such complications, in our experience, ePTFE use in LDLT continues to have wide safety margin, with a complication rate of only 1.52%. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|