Abstract:

Introduction: arterial complications after orthotopic liver transplantation are common cause of graft loss (10-40%).

Aim: was to estimate efficiency of endovascular interventions in correction of revealed arterial complications in patients after OLT.

Material and methods: for the period of 2015-2020, arterial complications after 104 OLT were revealed in 24(23%) pts and were divided into 4 groups: «steal»-syndrome (n=8), hepatic artery thrombosis (n=7), combination of hepatic artery stenosis and «steal» syndrome (n=6), hepatic artery stenosis (n=3). Endovascular interventios such as splenic artery embolization, direct thrombolysis, stenting and balloon plastic were performed for correction of these complications.

Results: using of endovascular treatment, we successfully identified and correct complications with saving of the graft in 14 pts (58%), 10 pts died because of biliary necrosis, sepsis and graft loss.

Conclusion: early detection and elimination of emerging arterial complications after OLT play a keyrole in saving of organs and patients’ life.

References

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Abstract:

Aim: was to estimate efficacy of methods of permanent or temporary blocking of blood flow through the gastroduodenal artery (GDA) during arterial chemoinfusion/chemoembolization of hepatic and pancreatic malignancies.

Materials and methods: for the period of 5 years (2015-2019), GDA embolization with coils was performed in 90 patients. Of them, 39 patients with liver tumors underwent occlusion of proximal GDA. GDA embolization distally to pancreatic branches (commonly on the level of gastroepiploic artery) was done in 51 patients with pancreatic head adenocarcinoma. Alternatively, in 12 patients with liver and 23 patients with pancreatic cancer, hand compression of GDA was used.

Results: technical success was 98% (88/90 patients). During embolization, coil migration into the hepatic artery developed in two patients with liver tumors: in one case stenting of the common hepatic artery was performed, the other case was asymptomatic and the presence of coil did not complicate the following arterial therapy. There were no other complications. Patients received multiple repeated courses of arterial chemotherapy.

Conclusion: methods of blocking of GDA blood flow are relatively safe, effective, simple and inexpensive. Both, embolization and hand compression, help to prevent non-target chemoinfusion and embolization.

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http://doi.org/10.3390/icm7050101

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Abstract:

A 57-year-old woman was on the waiting list of Orthotopic Liver Transplantation (OLT) due to cirrhosis of viral etiology MSCT with contrast enhancement showed two aneurysms of the splenic artery, stenosis of the celiac trunk with aneurysm of the pancreaticoduodenal artery Taking into account asymptomatic course, we decided to eradicate vascular changes during the forthcoming OLT OLT performed 6 month later, was technically difficult and complicated by massive blood loss and episodes of unstable hemodynamics, so surgical correction of aneurysms was not performed because of high risk. The patient was well and asymptomatic for 2 years after the OLT, but then she developed abdominal pain. MSCT showed progression of vascular changes. Successful endovascular treatment included celiac trunk stenting and embolization of aneurysms. 

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