[Aggressive management of the arterial complications of liver transplantation. Impact upon survival and biliary complications].
A study was made of the arterial complications documented in 400 transplants performed between 1997 and 2006. The patients were divided into two groups according to the type of treatment provided. Group I: invasive management (arterial treatment or re-transplant), and Group II: conservative or symptomatic management. The impact of management upon survival and biliary complications was analysed.


RESULTS
There were 18 arterial complications (4.5%): 10 early (7 thromboses and 3 stenoses) and 8 late (5 thromboses and 3 stenoses). Ninety percent of the early complications were subjected to invasive management (4 emergency thrombectomies, 1 re-transplant and 3 angioplasties), while 25% of the late complications were treated in the form of re-transplant and the remaining 75% were subjected to symptomatic treatment. Survival after 12 and 60 months was lower in Group II (57% and 42%) than in Group I (90% and 68%), although without reaching statistical significance. The overall biliary complications rate among the patients with arterial thrombosis was 50%. The rate was significantly lower in Group I than in Group II (10% versus 71%) (P<04).


CONCLUSIONS
Invasive management of the arterial complications of liver transplantation is associated with longer short-term survival and significantly fewer biliary complications. In our experience, patients benefit from an early diagnosis and aggressive management of complications of this kind.
Fernández Aguilar
José Luís
JL
Servicio de Cirugía General y Digestiva y Trasplante de Organos Abdominales, Hospital Universitario Carlos Haya, Málaga, España. jlfaguilar@telefonica.net
Suárez-Muñoz
Miguel Angel
MA
Santoyo Santoyo
Julio
J
Sánchez Pérez
Belinda
B
Pérez Daga
Antonio
A
Ramírez Plaza
César P
CP
Aranda Narváez
José Manuel
JM
González Sánchez
Antonio
A
Montiel Casado
Custodia
C
Carrasco Campos
Joaquín
J
Alvarez Alcalde
Antonio
A
D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D001660:Biliary Tract Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate