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Vascular complications after liver transplantation

BACKGROUND: The authors present the vascular complications observed in an academic Brazilian hepatic transplantation division. METHODS: Hospital charts of all patients who were submitted to a liver transplantation between of September 1991 and January 2000, were evaluated to determine vascular complications and to correlated them to clinical data and surgical procedures. RESULTS: Of a total of 169 tranplantations performed, four were from living related donors and 9 retransplantations. Twenty-four vascular complications (14,3%) were identified in 22 patients (13,0%), the most common being hepatic artery thrombosis (15 cases) and portal vein thrombosis (4 cases). Complications of the infra and suprahepatic vena cava were observed in three cases (1,8%). Vascular complications were more common in children (26,06%) than in adults (13,14%) (p<0,05). From the patients with hepatic artery thrombosis, one was submitted to an angioplasty, one to a thrombectomy, while eight underwent retransplantation and five died waiting for retransplantation. Of the patients with portal vein thrombosis, two died, one submitted to an endovascular stent placement, and one to conservative treatment. Patients with stenosis of the portal vein and of the infra and suprahepatic inferior vena cava received a conservative treatment, with good clinical recovery. CONCLUSION: Vascular complications are frequent after liver transplantation, mainly with children. They are associated with an elevated rate of morbidity, mortality and retransplantation.

Hepatic transplantation; Vascular complications; Venous thrombosis; Arterial thrombosis


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