Cimsit Bayindir, Yankol Yucel, Mecit Nesimi, Kanmaz Turan, Acarli Koray, Kalayoglu Munci
From the Department of Transplant Surgery, Istanbul Memorial Hospital, Istanbul, Turkey.
Exp Clin Transplant. 2015 Oct;13(5):482-4. doi: 10.6002/ect.2013.0298. Epub 2014 Jun 9.
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.
