Improving hepatic and portal venous flows using tissue expander and Foley catheter in liver transplantation
| Autor: | Yu-Fan Cheng, Yaw-Sen Chen, Kuo-Chen Hung, Yueh-Wei Liu, Chin-Hsiang Yang, Bruno Jawan, Chee-Chien Yong, Allan M. Concejero, Tsan-Shiun Lin, Chih-Chi Wang, Chih-Che Lin, Salleh Ibrahim, Shih-Ho Wang, Chao-Long Chen |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Foley catheter Liver transplantation Catheterization Postoperative Complications Chylous ascites medicine Humans Postoperative Period Vascular Diseases Vein Transplantation Foley business.industry Infant Tissue Expansion Devices Ultrasonography Doppler Middle Aged Venous Obstruction Liver Transplantation Surgery Portal System Catheter medicine.anatomical_structure Liver Regional Blood Flow Female Radiology business Blood Flow Velocity |
| Zdroj: | Clinical Transplantation. 20:81-84 |
| ISSN: | 1399-0012 0902-0063 |
| Popis: | Blackwell Munksgaard, 2005Abstract: Background and objective: Vascular reconstruction isimportant in liver transplantation because its obstruction causes graftfailure and eventual loss. Vascular outflow obstruction may be dueto graft malposition. We describe our experience with liver allograftrepositioning using tissue expander and Foley catheter to improvehepatic and portal venous outflows.Patients and methods: A total of seven patients who received livertransplantationatourinstitutiondevelopedhepaticand/orportalvenousobstruction during final graft positioning detected by Doppler ultra-sonography (hepatic vein flow o10cm/s; portal vein flow o12cm/s).Chart and operative records of these patients were reviewed. Techniqueof operation, donor–recipient characteristics, use of tissue expander orFoley catheter to improve venous outflow, complications, and outcomewere analyzed.Results: Hepatic and/or portal venous obstruction were detected afterportalreperfusion.Weusedcommerciallyavailabletissueexpanderusedinplastic surgery and Foley catheter to re position the graft. Tissue expanderswere used in three recipients (age: 27–46yr). Foley catheters were used infour recipients (age: 7 months–53yr). One recipient used both tissueexpanderandFoleycatheter.Expanderswerefilledwith300–770mLsalineand placed into the right subphrenic spa ce. Foley catheters were filled with15–75mLsaline.Significantimprovementsinhepaticand/orportalvenousoutflowweredetectedbyDopplerultraso nographypost-graftrepositioning.AspirationofexpanderandFoleycathetercontentswasstartedfrom6thto27th postoperative day under sonographic guidance. All expanders andcatheters were removed by the 19th–56th postoperative day (mean: 38d).Complications included chylous ascites (1/7), bile leak (1/7), tube draininfection (2/7), septicemia (2/7). Al l complications were successfullymanagedbynon-operativeinterventions.Therewasnooutflowobstructiondetected by ultrasonography before and after removal of expanders andcatheters. One- and two-year graft and patient survivals were both 100%.Conclusion: The use of tissue expanders and Foley catheters to improvehepaticandportalvenousoutflowinmalposedliverallograftsisasimpleandsafe method after liver transplantation.catheter – liver transplantation – tissue expanderCorresponding author: Chao-Long Chen MD,Key words: allograft malposition – Foley |
| Databáze: | OpenAIRE |
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