Prevalence, presentation, and endovascular management of hemodynamically or clinically significant arterio-portal fistulae in living and cadaveric donor liver transplant recipients

被引:10
|
作者
Saad, Wael [1 ]
Lippert, Allison [1 ]
Davies, Mark [1 ]
Arslan, Bulent [1 ]
Kumer, Sean [2 ]
Waldman, David [3 ]
Turba, Ulku [1 ]
Schmitt, Timothy [2 ]
Matsumoto, Alan [1 ]
Angle, John [1 ]
机构
[1] Univ Virginia Hlth Syst, Dept Radiol, Div Vasc Intervent Radiol, Charlottesville, VA USA
[2] Univ Virginia Hlth Syst, Dept Surg, Div Solid Organ Transplantat, Charlottesville, VA USA
[3] Univ Rochester, Med Ctr, Dept Imaging Sci, Rochester, NY 14642 USA
关键词
arterial; embolization; fistula; portal; transplant; VASCULAR COMPLICATIONS; BIOPSY; GRAFT; CHILD;
D O I
10.1111/j.1399-0012.2011.01547.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Saad W, Lippert A, Davies M, Arslan B, Kumer S, Waldman D, Turba U, Schmitt T, Matsumoto A, Angle J. Prevalence, presentation, and endovascular management of hemodynamically or clinically significant arterio-portal fistulae in living and cadaveric donor liver transplant recipients. Abstract: Purpose: To compare the prevalence (cadaveric vs. living donor transplants), clinical features, and the effectiveness of endovascular management of significant arterio-portal fistulae (APF) in liver transplant recipients. Methods: A retrospective audit of liver transplant recipients in two institutions was performed (19962009). Significant APF were included and were defined as symptomatic and/or hemodynamically significant (causing graft dysfunction and/or having abnormal Doppler findings in the portal vein). Patients with significant APF were evaluated for presenting symptoms, imaging features, size/branch order portal vein involvement, and effectiveness of the endovascular management (coil embolization). Results: Four significant APF were found in 1992 (0.2%) liver transplants. Two were symptomatic and two were asymptomatic but were hemodynamically significant with liver function test abnormalities. All four APF were found in cadaveric donor graft recipients (0.23%, N = 4/1753) and none in 239 living donor graft recipients. However, there was no statistical difference between cadaveric and living donor graft recipients (p = 1.0, odds ratio = 1.23). Coil embolization was technically and clinically successful in all 4 without complications and causing normalization of the abnormal Doppler findings. Conclusion: Significant APF are a rare diagnosis (0.2% of transplants). Coil embolization is a safe and effective treatment option for APF in transplants.
引用
收藏
页码:532 / 538
页数:7
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