Orthotopic liver transplantation: postoperative complications and their management
Autor: | W. A. Jurewicz, A. B. Jain, Stefan G. Hubscher, M. Sealey, Bridget Gunson, Paul McMaster, David H. Adams, Luigi Angrisani, D. Clements, Jac Buckels, Elwyn Elias, R. M. Kirby, P. J. Salt |
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Rok vydání: | 1987 |
Předmět: |
Adult
Graft Rejection Reoperation medicine.medical_specialty Adolescent Cholangitis medicine.medical_treatment Hemorrhage Liver transplantation Opportunistic Infections Postoperative Complications Liver Function Tests Cyclosporin a medicine Humans Child Duodenal Perforation medicine.diagnostic_test business.industry Liver Diseases Acute Kidney Injury Middle Aged medicine.disease Surgery Liver Transplantation Bowel obstruction medicine.anatomical_structure Abdomen Epilepsy Tonic-Clonic Liver function tests business Complication Abdominal surgery |
Zdroj: | The British journal of surgery. 74(1) |
ISSN: | 0007-1323 |
Popis: | The Birmingham liver transplant programme started in 1982. Forty-six patients have been transplanted with a follow-up of 3 months or longer. Twenty-seven patients are still alive, of whom sixteen have lived for more than one year. The 30 day hospital mortality was 30·4 per cent and the actuarial predicted one year survival 55·5 per cent. Four patients have been regrafted for chronic rejection and graft failure. Thirteen patients have required surgery in the postoperative period for: bleeding (two), removal of abdominal packs (four), biliary leaks and obstruction (five), duodenal perforation (one) and small bowel obstruction (one). Acute rejection was common, occurring in 30 patients and progressing to chronic rejection in 4. Ten patients developed renal failure with an 80 per cent mortality and eleven patients developed grand mal fits. Severe bleeding (>70 units) was associated with previous abdominal surgery and a high mortality (88·9 per cent). Opportunistic fungal infection carried a 100 per cent mortality. Although more than half of all transplanted patients will survive for more than one year, the postoperative period is still one of high morbidity and mortality. |
Databáze: | OpenAIRE |
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