In order to evaluate the incidence of postoperative surgical complications requiring additional surgery, we report 73 consecutive liver orthotopic transplantations performed in 60 patients from June 1983 through June 1989. Transplantations were performed in 54 adults and 6 children for the following reasons: postnecrotic cirrhosis in 31, biliary diseases in 16, hepatobiliary malignancy in 7; Wilson's diseases in 3 and fulminant hepatitis in 3. Surgical complications requiring additional surgery occurred in 35 (58%) patients with 53 operations. Twenty-two patients (36%) had postoperative bleeding complications, 5 (8%) biliary complications, one had a late artery thrombosis and 16 (26%) had miscellaneous complications. The latter group included 6 abdominal hernias, 3 bowel perforations, 2 bowel obstructions, 2 cases of pneumothorax, 2 cases of chylous ascitis, one liver necrosis, one hepatic artery kinking, one peritonitis and one cardiac tamponade. The incidence of surgical complications was not significantly different in patients who underwent retransplantation as compared to those who had a single transplantation. We did not find a significant difference in surgical complication rate according to the preoperative liver disease. In comparison with the literature, in our series, we had a higher rate of abdominal hernia but a lower rate of biliary complications.

Adolescent↗

PubMed1991

[Hepatitis B and D recurrence after liver transplantation].

In Italy, many patients with B-virus (HBV) and Delta-virus (HDV) end-stage liver disease, are potential candidates to liver transplantation. Several authors have reported 70 to 100% hepatitis recurrence rates. From june 1983 to may 1989, 72 transplants on 60 patients were performed at Liver Transplantation Department of the Maggiore-Policlinico Hospital of Milan. The results in 26 HBsAg positive patients (19 with HDV infection), that underwent liver transplantation, are reported. A detailed report of 17 of these patients with a follow-up longer 7 months, and the clinical course of 4 patients with HBV reinfection, 3 of which had hepatitis recurrence, is also presented. The occurrence of HDV-RNA in the serum of 5 patients, that were negative for HBsAg and also other HBV-HDV replication markers after transplantation is discussed, together with the observation that in these patients no hepatitis recurrences or alteration of the clinical course were evident.

Biomarkers↗

PubMed1991