Aggressive management of the arterial complications of liver transplantation. Impact upon survival and biliary complications

• Published in: Cirugia española (English ed.) 2010, Vol.87 (3), p.155-158
• Main Authors: Fernández Aguilar, José Luis, Suárez-Muñoz, Miguel Ángel, Santoyo Santoyo, Julio, Sánchez Pérez, Belinda, Pérez Daga, Antonio, Ramírez Plaza, César P, Aranda Narváez, José Manuel, González Sánchez, Antonio, Montiel Casado, Custodia, Carrasco Campos, Joaquín, Álvarez Alcalde, Antonio
• Format: Article
• Language: English
• Subjects: Arterial stenoses; Arterial thromboses; Complicaciones; de la arteria hepática; Estenosis arterial; Hepatic arterial complication; Liver transplant; Surgery; Trasplante hepático; Trombosis arterial
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/S2173-5077(10)70175-7

Abstract A study was made of the arterial complications documented in 400 transplants performed between 1997 and 2006. The patients were divided into two groups according to the type of treatment provided. Group I: invasive management (arterial treatment or re-transplant), and Group II: conservative or symptomatic management. The impact of management on survival and biliary complications was analysed. Results There were 18 arterial complications (4.5%): 10 early (7 thromboses and 3 stenoses) and 8 late (5 thromboses and 3 stenoses). Ninety percent of the early complications were subjected to invasive management (4 emergency thrombectomies, one re-transplant and 3 angioplasties), while 25% of the late complications were treated with re-transplant and the remaining 75% were subjected to symptomatic treatment. Survival after 12 and 60 months was lower in Group II (57% and 42%) than in Group I (90% and 68%), although without reaching statistical significance. The overall biliary complications rate among the patients with arterial thrombosis was 50%. The rate was significantly lower in Group I than in Group II (10% versus 71%) (P