Isolated venous thrombosis: a new cause of acute graft failure in a non-piggyback liver transplant (case report).
A 46-year-old man was re-transplanted using standard technique for hepatic arterial thrombosis one month following orthotopic liver transplant. Postoperatively he deteriorated acutely with hypotension and disseminated intravascular coagulation. Angiography demonstrated a patent hepatic artery, portal vein and inferior vena cava but isolated thromboses in the right and middle hepatic veins. He was treated with transvenous intrahepatic porto-systemic shunt but subsequently died from sepsis and multiorgan failure. This vascular complication in the absence of outflow stenosis and with a normal prothrombotic screen is a previously undocumented cause of acute graft failure in a standard transplant without retrohepatic vena caval preservation. We present our case and discuss the relevant literature.
Robertson
Andrew G N
AG
University Department of Surgery, Royal Free Hospital & Royal Free & University College School of Medicine, University College London, UK.
Burroughs
Andrew
A
Davidson
Brian R
BR
D006502:Budd-Chiari Syndrome / Q000150:complications* / Q000209:etiology; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D017114:Liver Failure, Acute / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure; D011170:Portasystemic Shunt, Surgical