Pérez-Saborido B, Pacheco-Sánchez D, Barrera-Rebollo A, Asensio-Díaz E, Pinto-Fuentes P, Sarmentero-Prieto J C, Rodríguez-Vielba P, Martínez-Díaz R, Gonzalo-Martín M, Rodríguez M, Calero-Aguilar H, Pintado-Garrido R, García-Pajares F, Anta-Román A
Surgery Department, Universitary Rio Hortega, Hospital Valladolid, Valladolid, Spain.
Transplant Proc. 2011 Apr;43(3):749-50. doi: 10.1016/j.transproceed.2011.01.104.
Vascular complications show an 8%-15% incidence after liver transplantation and represent an important cause of mortality. An aggressive policy is necessary for an early diagnosis and treatment.
From 2001 to 2009, we performed 240 liver transplantations in 232 patients. We employed Doppler ultrasonography on days 1 and 4 as well as before hospital discharge and always try a radiological approach.
The incidence of vascular complications was 7.2% (n = 18) including arterial (n = 12, 4.8%) of early thrombosis (n = 4), late thrombosis (n = 4), and stenosis (n = 4) or portal (n = 3; 1.2%) of thrombosis (n = 2) or stenosis (n = 1); or caval complications (n = 3, 1.2%). Radiologic therapy was effective in 1 patient with arterial stenosis, in the 3 patients with portal complications, and in 2 patients with caval complications. All patients with early thrombosis and 2/4 with late thrombosis required retransplantation. Surgical treatment was effective in 1 patient with late thrombosis, 3 with stenosis, and 2 with caval complications. The overall mortality rate was 16.6%; 2 patients with arterial complications and 1 with a caval complications.
Vascular complications, mainly artery complications, represent serious problem after liver transplantation, which often requires retransplantation. With an aggressive policy of diagnosis and treatment, we can decrease the mortality rate from these adverse events.
血管并发症在肝移植后发生率为8%-15%，是一个重要的死亡原因。采取积极的策略进行早期诊断和治疗很有必要。
2001年至2009年，我们对232例患者实施了240例肝移植手术。在术后第1天和第4天以及出院前均采用多普勒超声检查，并始终尝试采用放射学方法。
血管并发症的发生率为7.2%（n = 18），包括动脉并发症（n = 12，4.8%），其中早期血栓形成（n = 4）、晚期血栓形成（n = 4）和狭窄（n = 4）；或门静脉并发症（n = 3；1.2%），其中血栓形成（n = 2）或狭窄（n = 1）；或腔静脉并发症（n = 3，1.2%）。放射治疗对1例动脉狭窄患者、所有3例门静脉并发症患者和2例腔静脉并发症患者有效。所有早期血栓形成患者以及4例晚期血栓形成患者中的2例需要再次移植。手术治疗对1例晚期血栓形成患者、3例狭窄患者和2例腔静脉并发症患者有效。总死亡率为16.6%；2例动脉并发症患者和1例腔静脉并发症患者死亡。
血管并发症，主要是动脉并发症，是肝移植后的严重问题，常需要再次移植。通过积极的诊断和治疗策略，我们可以降低这些不良事件的死亡率。
