Vascular complications after deceased and living donor liver transplantation: a single-center experience.
BACKGROUND
Vascular complications (VC) after liver transplantation (OLT) are one of the most feared problems that frequently result in graft and patient loss. Herein we have reported our experience with VC after either deceased donor liver transplantation (DDLT) or living donor liver transplantation (LDLT).


METHODS
Between April 2001 and September 2009, we performed 224 OLT: 155 DDLT and 69 LDLT. The overall male/female ratio was 136/88 and the adult/pediatric ratio was 208/16. We retrospectively identified and analyzed vascular complications in both groups.


RESULTS
In the DDLT group, 11/155 recipients (7%) suffered vascular complications; hepatic artery thrombosis (HAT; n=5; 3.2%), portal vein thrombosis occurred (n=4; 2.6%); hepatic vein stenosis (n=1; 0.6%), and severe postoperative bleeding due to a slipped splenic artery ligature (n=1, 0.6%). In the DDLT group, 4/11 (36.4%) patients died as a direct result of the vascular complications. In the LDLT group, 9/69 recipients (13%) suffered vascular complications: HAT (n=3; 4.3%), portal vein problems (n=5; 7.2%), and hepatic vein stenosis (n=1; 1.5%). Among LDLT, 3/9 (33.3%) patients died as a direct result of the vascular complications. In both groups vascular complications were associated with poorer patient and graft survival.


CONCLUSIONS
In our experience, the incidence of vascular complications was significantly higher among the LDLT group compared with the DDLT group. Vascular complications were associated with poorer graft and patient survival rates in both groups.
Khalaf
H
H
Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. hatem@khalaf.us
D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D002648:Child; D005260:Female; D006085:Graft Survival; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate; D013927:Thrombosis / Q000453:epidemiology; D014019:Tissue Donors; D020246:Venous Thrombosis / Q000453:epidemiology