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Published on: November 7, 2020
Vascular complications after deceased and living donor liver transplantation: a single-center experience
1Department of Liver Transplantation and Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. hatem@khalaf.us
Insights
Vascular complications after liver transplantation are serious. Living donor liver transplantation had a higher incidence of these complications, impacting patient survival.
Area of Science:
- Transplantation Surgery
- Vascular Surgery
- Hepatobiliary Surgery
Background:
- Vascular complications (VC) are a significant concern following liver transplantation (OLT), often leading to graft and patient loss.
- This study examines VC in both deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT).
Purpose of the Study:
- To compare the incidence and outcomes of vascular complications in DDLT versus LDLT.
- To analyze the impact of VC on patient and graft survival after OLT.
Main Methods:
- Retrospective analysis of 224 OLT cases (155 DDLT, 69 LDLT) performed between April 2001 and September 2009.
- Identification and analysis of vascular complications, including hepatic artery thrombosis, portal vein thrombosis, and hepatic vein stenosis.
Main Results:
- The overall incidence of VC was 7% in DDLT and 13% in LDLT.
- Specific complications included hepatic artery thrombosis (HAT), portal vein thrombosis, and hepatic vein stenosis in both groups.
- VC were associated with significantly poorer patient and graft survival in both DDLT and LDLT recipients.
Conclusions:
- Living donor liver transplantation demonstrated a higher incidence of vascular complications compared to deceased donor liver transplantation.
- Vascular complications remain a critical factor negatively affecting survival rates in liver transplant recipients.
Introduction:
Vascular complications (VC) after liver transplantation (OLT) are one of the most feared problems that frequently result in graft and patient loss. Herein we have reported our experience with VC after either deceased donor liver transplantation (DDLT) or living donor liver transplantation (LDLT).
Patients And Methods:
Between April 2001 and September 2009, we performed 224 OLT: 155 DDLT and 69 LDLT. The overall male/female ratio was 136/88 and the adult/pediatric ratio was 208/16. We retrospectively identified and analyzed vascular complications in both groups.
Results:
In the DDLT group, 11/155 recipients (7%) suffered vascular complications; hepatic artery thrombosis (HAT; n=5; 3.2%), portal vein thrombosis occurred (n=4; 2.6%); hepatic vein stenosis (n=1; 0.6%), and severe postoperative bleeding due to a slipped splenic artery ligature (n=1, 0.6%). In the DDLT group, 4/11 (36.4%) patients died as a direct result of the vascular complications. In the LDLT group, 9/69 recipients (13%) suffered vascular complications: HAT (n=3; 4.3%), portal vein problems (n=5; 7.2%), and hepatic vein stenosis (n=1; 1.5%). Among LDLT, 3/9 (33.3%) patients died as a direct result of the vascular complications. In both groups vascular complications were associated with poorer patient and graft survival.
Conclusions:
In our experience, the incidence of vascular complications was significantly higher among the LDLT group compared with the DDLT group. Vascular complications were associated with poorer graft and patient survival rates in both groups.
