Causes of arterial bleeding after living donor liver transplantation and the results of transcatheter arterial embolization.
OBJECTIVE
To analyze the causes of arterial bleeding after living donor liver transplantation (LDLT) and to evaluate the efficacy of transcatheter arterial embolization (TAE).


METHODS
Forty-two sessions of conventional arteriography were performed in 32 of the 195 patients who underwent LDLT during the past 2 years. This was done in search of bleeding foci of arterial origin. TAE was performed with microcoils or gelatin sponge particles. The causes of arterial bleeding, the technical and clinical success rates of TAE and the complications were retrospectively evaluated.


RESULTS
Forty-two bleeding foci of arterial origin were identified on 30 sessions of arteriography in 21 patients. The most common cause of bleeding was percutaneous procedures in 40% of the patients (17 of the 42 bleeding foci) followed by surgical procedures in 36% (15/42). The overall technical and clinical success rates of TAE were 21 (70%) and 20 (67%) of the 30 sessions, respectively. The overall technical success rate of TAE for the treatment of bleeding from the hepatic resection margin, hepatic artery anastomotic site and hepaticojejunostomy was only 18% (2/11), whereas for the treatment of bleeding in the other locations the technical and clinical success rates of TAE were 100% and 95%, respectively. No procedure-related major complications occurred.


CONCLUSIONS
In the case of arterial bleeding after LDLT, percutaneous procedure-related hemorrhages were as common as surgery-related hemorrhages. There were technical difficulties in using TAE for the treatment of hepatic arterial bleeding. However, in the other locations, TAE seems to be safe and effective for the control of arterial bleeding in LDLT recipients.
Department of Radiology, Inha University, College of Medicine, Seoul, Korea.
Jeong Ho
JH
Kim
Gi-Young
GY
Ko
Hyun-Ki
HK
Yoon
Ho-Young
HY
Song
Sung-Gyu
SG
Lee
Kyu-Bo
KB
Sung
D000293:Adolescent; D000328:Adult; D002648:Child; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome