Extra-anatomical hepatic artery reconstruction following post-embolization iatrogenic dissection and arterial anastomotic rupture in two liver transplant recipients.
When hepatic artery reconstruction is required during hepatic transplantation, this is generally performed with donor vessels. We describe two cases requiring a prosthesis. The first case was a 58-year-old man transplanted for cirrhosis complicated by hepatocellular carcinoma. During transplantation, dissection of the celiac trunk occurred due to arterial embolization and the use of the patient's vessels was impossible. An extra-anatomical bypass between the infra-renal aorta and the donor hepatic artery was performed via the interposition of a graft tube. The second case was a 52-year-old man transplanted for cirrhosis complicated by hepatocellular carcinoma. On day 16, a ruptured anastomosis was suspected and the patient underwent emergency revision laparotomy. Arterial revascularisation was performed with an aortohepatic bypass using a synthetic GoreTex((R)) graft. Patient follow-up was uneventful.
Golse
N
N
Department of Hepatobiliopancreatic Surgery and Liver Transplantation, Edouard Herriot Hospital, HCL, UFR Grange Blanche-UCBL1, Pavillon D 5, Place d'Arsonval, 69437 Lyon cedex, France.
Spina
A
A
Abdelaal
A
A
Mennesson
N
N
Feugier
P
P
Dumortier
J
J
Boillot
O
O
Adham
M
M
D000714:Anastomosis, Surgical / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000009:adverse effects; D006499:Hepatic Artery / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012421:Rupture