title: [Subcapsular hematoma and rupture of the liver graft].
abstract: Subcapsular hematoma and/or rupture of the graft is uncommon but serious complication of liver transplantation. It may develop spontaneously or following parenchymal injuries or percutaneous transhepatic invasive procedures. This report describes three cases of subcapsular hematoma and/or rupture of the graft with different courses among 350 liver transplantations. In the first case, the patient died due to graft rupture caused by a pseudoaneurysm after biopsy. In the second case, a small injury of the donor liver resulted in a deep rupture, which required partial resection of the graft. The patient died in sepsis later. The third patient presented with a large subcapsular haematoma during transplantation, which was successfully treated. The authors' strategies developed intraoperatively for the management of hematomas. These involve opening and removing of the haematoma, haemostasis with Argon coagulation, which resulted in an adherent Glisson's capsule to the parenchyma and covering with collagen fleece coated with fibrinogen and thrombin.
authors.affiliation: Semmelweis Egyetem, Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika 1082 Budapest Baross u. 23. gorogd@freemail.hu
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Máthé
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.forename: Jeno
authors.initials: J
authors.lastname: Járay
mesh_terms: D000293:Adolescent; D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006406:Hematoma / Q000150:complications* / Q000209:etiology; D019693:Hepatitis, Autoimmune / Q000150:complications; D006527:Hepatolenticular Degeneration / Q000150:complications; D006801:Humans; D017093:Liver Failure / Q000150:complications* / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009145:Mushroom Poisoning / Q000150:complications; D012422:Rupture, Spontaneous / Q000150:complications / Q000209:etiology; D012771:Shock, Hemorrhagic / Q000209:etiology*