Celiac compression syndrome and liver transplantation

Area of Science:

• Hepatology
• Vascular Surgery
• Transplantation Medicine

Background:

• Median arcuate ligament syndrome can compromise celiac artery blood flow.
• This compromise may lead to hepatic artery thrombosis in liver transplant recipients.
• Celiac artery compression poses a risk to orthotopic liver transplantation outcomes.

Purpose of the Study:

• To determine the prevalence of celiac compression syndrome in liver transplant patients.
• To evaluate the clinical significance and management of this syndrome.
• To assess the impact on hepatic artery blood flow and graft survival.

Main Methods:

• Retrospective analysis of 164 adult liver transplant patients from July 1991 to July 1992.
• Diagnosis confirmed by blood flow recordings showing decreased celiac artery flow during expiration.
• Surgical intervention included median arcuate ligament transection or arterial reconstruction with grafts.

Main Results:

• Celiac compression syndrome was identified in 17 patients (10%).
• Surgical transection normalized hepatic artery blood flow in most cases.
• Arterial reconstruction with grafts was used in two cases; no hepatic artery thrombosis occurred during follow-up.

Conclusions:

• Celiac compression syndrome is clinically significant in liver transplantation due to compromised collateral circulation.
• Identifying and releasing celiac axis obstruction is crucial.
• Prompt intervention prevents severe complications and potential graft loss in liver transplant recipients.