Thoracoabdominal bypass graft with liver retransplantation for the treatment of a pseudoaneurysm of the supraceliac aorta after liver transplantation.
Pseudoaneurysm following liver transplantation is a rare but life-threatening complication. Treatment is directed towards control of fatal bleeding. Ligation with or without revascularization of the graft is the treatment of choice. When revascularization is not possible, or the liver does not tolerate the arterial blood deprivation, retransplantation is the only option. We report a case of a 14-month-old girl who developed a pseudoaneurysm at the anastomosis between the recipient supraceliac aorta and the donor graft. The pseudoaneurysm was excised and the aorta was ligated above and below it. An extra-anatomical thoracoabdominal arterial graft was used to provide arterial blood supply to the lower torso and also to arterialize a new orthotopic liver graft. This is the first reported case of the use of thoracoabdominal jump graft to vascularize a transplanted liver.
Department of Surgery, University of Miami, School of Medicine, Florida, USA.
R
R
Verzaro
S
S
Nishida
M
M
Angelis
F
F
Khan
A
A
Tzakis
D000714:Anastomosis, Surgical / Q000379:methods; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D011859:Radiography; D012086:Reoperation / Q000379:methods