[Etiology and management of postoperative gastrointestinal bleeding after orthotopic liver transplantation].
OBJECTIVE
To investigate the causes and treatment of postoperative gastrointestinal bleeding after orthotopic liver transplantation (OLT).


METHODS
Clinical data of 776 patients after OLT between January 2000 and December 2006 were analyzed retrospectively.The experiences in diagnosis and treatment of postoperative gastrointestinal bleeding after OLT were reviewed.


RESULTS
Gastrointestinal bleeding occurred in 18 patients (2.3%) after OLT, among whom 8 (44.5%) were from peptic ulcer, 3 (16.7%) from gastric and esophageal varices, 3 (16.7%) from gastroduodenitis, 3 (16.7%) from hemobilia, and 1 (5.6%) had diverticular bleeding in the jejunum. These 18 patients with gastrointestinal bleeding were managed with conservative treatment, endoscopic treatment, radiological interventional embolism,or exploratory laparotomy. Five patients died of gastrointestinal bleeding and the gastrointestinal bleeding-related mortality rate was 27.8%. After a mean follow up of 3.5 years, only 1 patient died of recurrence of hepatic cellular carcinoma while others survived disease-free.


CONCLUSIONS
Gastrointestinal bleeding may occur from different sites after OLT and the mortality is high. Prompt identification of the source of bleeding and correct management are required to improve the prognosis.
Ma
Yi
Y
Departmentment of Transplantation Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. anhuimayi2002@163.com
He
Xiao-Shun
XS
Zhu
Xiao-Feng
XF
Wang
Guo-Dong
GD
Wang
Dong-Ping
DP
Hu
An-Bin
AB
Ju
Wei-Qiang
WQ
Wu
Lin-Wei
LW
Tai
Qiang
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies; D055815:Young Adult