Hepatic artery thrombosis remains a significant cause of graft loss in liver transplantation. We describe a case with thrombosis of the middle hepatic artery that revascularized spontaneously. Close follow-up with duplex ultrasound enabled us to treat the patient promptly and successfully with anticoagulants and antibiotics.

Adult↗

PubMedDate not supplied

Successful conservative therapy for portal vein thrombosis after living donor liver transplantation.

Portal vein thrombosis remains a significant cause of graft loss in liver transplantation. A case with thrombosis at the anastomotic site is described. Close follow-up with ultrasound enabled us to treat the patient promptly and successfully with anticoagulants.

Adolescent↗

PubMedDate not supplied

Thrombectomy of portal vein thrombosis in living donor liver transplantation.

We describe a case of living donor liver transplantation where an intrahepatic portal vein embolism was detected by intraoperative ultrasonography after the completion of portal and arterial anastomoses. The recipient portal vein trunk was clamped and the ligature of the graft's right portal branch was released, thus maintaining the sole arterial supply. Backward flushing of the portal system was achieved, which removed the clot through the reopened right portal branch without the need for thrombectomy by Fogarty balloon catheter.

Catheterization↗

PubMedDate not supplied

Lactate levels in cirrhotic patients undergoing liver resection.

BACKGROUND/AIMS: The role of lactate in liver ischemia-reperfusion injury in cirrhosis has not been clarified. METHODOLOGY: One hundred patients with hepatocellular carcinoma who underwent partial liver resection under Pringle's maneuver were included in this study. Blood lactate was measured before the operation, three times during the surgery and on the first postoperative day to calculate its rate of accumulation or elimination. Aminotransferase levels were also recorded perioperatively. We calculated the rate of lactate accumulation during the pre-ischemic and ischemic phases and the elimination rate during the post-ischemic phase, and examined the correlation between these results and the clinical findings. RESULTS: The rate of lactate accumulation during the pre-ischemic and ischemic phases was correlated with the preoperative indocyanine green retention rate (P = 0.04 and P = 0.004, respectively). The indocyanine green retention rate tended to be correlated with the rate of lactate elimination during the post-ischemic phase (P = 0.06). CONCLUSIONS: The blood lactate profile might be a reliable indicator of liver function during the perioperative period in cirrhotic patients who undergo liver resection with Pringle's maneuver.

Adult↗

PubMedDate not supplied

Restoration of portal vein flow by splenorenal shunt ligation and splenectomy after living-related liver transplantation.

We describe here a case of living-related liver transplantation with a spontaneous splenorenal shunt. On the third postoperative day, Doppler ultrasound follow-up revealed impairment of intrahepatic portal vein flow and reoperation was performed. Intraoperatively, simple compression of the collateral veins forming the splenorenal shunt resulted in an immediate change in the portal flow pattern, which suggested the absence of a portal thrombus. Splenectomy and ligature of the more dilated collateral veins were carried out and satisfactory portal flow was restored. Although the role of splenectomy was controversial, splenectomy provided an increased portal vein flow in the present case. The uneventful postoperative course validated our decision.

Adult↗