Therapeutic effect of hyperbaric oxygen in hepatic artery thrombosis and functional cholestasis after orthotopic liver transplantation.
Among the postoperative complications, hepatic artery thrombosis can occur in up to 10% of adult orthotopic liver transplants and intervention is indicated when this occurs within 30 days by retransplantation. Primary graft dysfunction, which can occur in up to 30% of the cases and is another potential complication, although reversible, has a relatively high mortality rate. Hyperbaric therapy, an efficient mode of tissue oxygenation, is being used in an increasing number of clinical situations. We report here two cases where hyperbaric oxygen therapy greatly benefited patients with complications after orthotopic liver transplantation: one with hepatic artery thrombosis and the other with primary graft dysfunction. Both patients showed rapid clinical recovery with gradual reduction of liver and canalicular enzymes soon after commencing hyperbaric oxygen therapy.
Castro e Silva
O
O
Special Liver Transplantation Unit, Departments of Surgery and Anatomy, Hospital das Clínicas, Ribeirão Preto School of Medicine, University of São Paulo, Av. Bandeirantes 3900, CEP 14049-900, Ribeirão Preto, São Paulo, Brazil. orlando@fmrp.usp.br
Sankarankutty
A K
AK
Martinelli
A L C
AL
Souza
F F
FF
Teixeira
A C
AC
Feres
O
O
Mente
E D
ED
Oliveira
G R
GR
Akita
R
R
Muglia
V
V
Elias
J
J
Ramalho
L N Z
LN
Zucoloto
S
S
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D006499:Hepatic Artery; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D013927:Thrombosis / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin