Sequential and simultaneous revascularization in adult orthotopic piggyback liver transplantation
| Autor: | S Miyamoto, Balázs Nemes, Koert P. de Jong, P. M. J. G. Peeters, W.G. Polak, Robert J. Porte, Maarten J. H. Slooff |
|---|---|
| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Adolescent medicine.medical_treatment Blood Loss Surgical PORTAL REVASCULARIZATION ALLOGRAFT Liver transplantation Anastomosis Revascularization Severity of Illness Index law.invention Liver Function Tests law Severity of illness Medicine Humans REPERFUSION Retrospective Studies Transplantation Hepatology medicine.diagnostic_test business.industry ARTERIALIZATION Graft Survival ORDER Retrospective cohort study Middle Aged Intensive care unit Survival Analysis DYSFUNCTION Surgery Liver Transplantation Liver Female Liver function business Liver function tests Erythrocyte Transfusion Vascular Surgical Procedures |
| Zdroj: | Liver Transplantation, 11(8), 934-940. Wiley |
| ISSN: | 1527-6465 |
| Popis: | The aim of the study was to assess whether there is a difference in outcome after sequential or simultaneous revascularization during orthotopic liver transplantation (OLT) in terms of patient and graft survival, mortality, morbidity, and liver function. The study population consisted of 102 adult patients with primary full-size piggyback OLT transplanted between January 1998 and December 2001. In 71 patients (70%) the grafts were sequentially reperfused after completion of the portal vein anastomosis and subsequent arterial reconstruction was performed (sequential reperfusion [SeqR] group). In 31 patients (30%) the graft was reperfused simultaneously via the portal vein and hepatic artery (simultaneous reperfusion [SimR] group). Patient and graft survival at 1, 3, and 6 months and at I year did not differ between the SeqR group and the SimR group. The red blood cell (RBC) requirements were significantly higher in the SimR group (5-5 units; range 0-20) in comparison to the SeqR group (2 units; range 0-19) (P = 0.02). Apart from a higher number of biliary anastomotic complications and abdominal bleeding complications in the SimR group in comparison to the SeqR group (13% vs. 2% and 19% vs. 6%, respectively; P = 0.06), morbidity was not different between the groups. No differences between the groups were observed regarding the incidence of primary nonfunction (PNF), intensive care unit stay, and acute rejection. This was also true for the severity of rejections. Postoperative recuperation of liver function was not different between the groups. In conclusion, no advantage of either of the 2 reperfusion protocols could be observed in this analysis, especially with respect to the incidence of ischemic type biliary lesions (ITBL). |
| Databáze: | OpenAIRE |
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