Zielsdorf Shannon, Kelly Beau, Genyk Yuri, Emamaullee Juliet
Department of Surgery, University of Southern California, Los Angeles, CA, USA.
Sierra Donor Services, Sacramento, CA, USA.
Case Rep Transplant. 2019 Apr 30;2019:4359197. doi: 10.1155/2019/4359197. eCollection 2019.
Central venous catheters (CVC) are commonly used across multiple medical specialties and are inserted for various reasons. A known, but rare, serious complication of CVC is fracture and retention of residual catheter. Here we describe a chronically retained catheter within the inferior vena cava (IVC) that was asymptomatic and neither diagnosed nor addressed until time of deceased donor liver donation. Prior to transplantation into the recipient, the retained catheter was removed, and a venoplasty of the suprahepatic IVC, middle hepatic vein, and left hepatic vein was performed with no significant issues after transplant in the recipient. With the persistent shortage of suitable organs for transplant leading to patients dying on the waiting list, every good quality organ should be carefully considered. Thus, even though a chronically retained, fractured CVC in a deceased organ donor presents a unique challenge, it can be managed surgically and should not be considered a contraindication to organ utilization.
中心静脉导管(CVC)在多个医学专科中广泛使用,其插入原因多种多样。CVC一种已知但罕见的严重并发症是导管断裂并残留。在此,我们描述了一例下腔静脉(IVC)内长期留置的导管,该导管无症状,在已故供体肝脏捐献时才被诊断和处理。在移植到受体之前,取出了留置的导管,并对肝上下腔静脉、肝中静脉和肝左静脉进行了静脉成形术,受体移植后未出现重大问题。由于适合移植的器官持续短缺,导致患者在等待名单上死亡,因此每个优质器官都应仔细考虑。因此,尽管已故器官供体中长期留置、断裂的CVC带来了独特挑战,但可以通过手术处理,不应被视为器官利用的禁忌证。