title: Calcification of Cryopreserved Arterial Graft Causing Delayed Obstruction of Portal Vein Flow After Liver Transplant.
abstract: In patients with biliary atresia, portal vein problems may cause challenges for liver transplant. Interposition grafts have been used for vascular anastomoses in transplant recipients with varied success. A cryopreserved iliac artery graft was used for the reconstruction of the portal vein in a 29-month-old infant with biliary atresia. At 17 months after transplant, she developed upper gastrointestinal bleeding that was caused by portal vein occlusion because of vascular calcifications in the graft. Upper gastrointestinal endoscopy showed esophageal varices with fresh bleeding, and the varices were band ligated. At 3 months after the bleeding episode, the patient was asymptomatic and biochemical tests were normal. In summary, liver transplant with cryopreserved iliac artery graft may be complicated by calcifications and portal vein occlusion, and caution is advised in using this graft material for portal vein anastomoses.
authors.affiliation: From the Department of Transplant Surgery, Istanbul Memorial Hospital, Istanbul, Turkey.
authors.forename: Bayindir
authors.initials: B
authors.lastname: Cimsit
authors.forename: Yucel
authors.initials: Y
authors.lastname: Yankol
authors.forename: Nesimi
authors.initials: N
authors.lastname: Mecit
authors.forename: Turan
authors.initials: T
authors.lastname: Kanmaz
authors.forename: Koray
authors.initials: K
authors.lastname: Acarli
authors.forename: Munci
authors.initials: M
authors.lastname: Kalayoglu
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D002675:Child, Preschool; D015925:Cryopreservation; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D008026:Ligation; D008102:Liver Circulation; D016031:Liver Transplantation / Q000009:adverse effects*; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology