ABSTRACT
The incidence of fungal complications is frequent among liver transplanted subjects. Between March 1986 and June 2009, we performed 670 liver transplants in 593 patients, including 61% males and an overall average age of 46. The incidence of arterial complications in our center was 5.3% (32/593 patients), including 24 (75%) thromboses, 5 (16%) pseudoaneurysms, 2 anastomotic stenoses, and 1 an iliac graft rupture owing to a mycotic aneurysm. Four patients presented arterial complications associated with Aspergillus sp. Three of them were males of mean age 50 years and 3 had an acute rejection episode. Immunosuppression was cyclosporine (CsA), steroids, and azathioprine. Four arterial complications were diagnosed: 2 thromboses and 2 pseudoaneurysm ruptures. Two patients presented biliary complications associated with the arterial complication and Aspergillus infection. Treatment was expectant in 1 patient, interventional radiology in an other, and retransplantation in the other 2. All patients infected with Aspergillus sp. diad of sepsis and multiorgan failure. Arterial complications posttransplant associated with infection by Aspergillus sp., can be an important cause of retransplantation, sepsis and death.
Subject(s)
Arteries/pathology , Aspergillosis/etiology , Liver Transplantation/adverse effects , Vascular Diseases/etiology , Female , Humans , Male , Middle AgedSubject(s)
Carcinoma, Hepatocellular/surgery , Liver Neoplasms/surgery , Liver Transplantation/statistics & numerical data , Adolescent , Adult , Aged , Carcinoma, Hepatocellular/pathology , Child , Female , Graft Survival , Humans , Liver Transplantation/mortality , Liver Transplantation/pathology , Male , Middle Aged , Neoplasm Staging , Retrospective Studies , Survival Rate , Treatment OutcomeSubject(s)
Liver Transplantation/statistics & numerical data , Adolescent , Adult , Child , Chronic Disease , Female , Graft Rejection/surgery , Hepatitis C/surgery , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/surgery , Reoperation/statistics & numerical data , Retrospective Studies , Time Factors , Treatment Failure , Treatment OutcomeSubject(s)
Anastomosis, Surgical/adverse effects , Celiac Artery/surgery , Hepatic Artery/surgery , Liver Transplantation/methods , Postoperative Complications/epidemiology , Adolescent , Adult , Aged , Aneurysm/epidemiology , Child , Female , Humans , Incidence , Liver Transplantation/adverse effects , Male , Middle Aged , Postoperative Complications/etiology , Reoperation , Retrospective Studies , Thrombosis/epidemiologySubject(s)
Liver Transplantation/physiology , Reoperation , Adult , Female , Hepatectomy/methods , Humans , Liver Diseases/classification , Liver Diseases/surgery , Liver Transplantation/methods , Liver Transplantation/pathology , Male , Reoperation/methods , Time Factors , Tissue and Organ Harvesting/methods , Treatment FailureSubject(s)
Cyclosporine/therapeutic use , Liver Regeneration , Liver Transplantation/physiology , Analysis of Variance , Animals , Biomarkers/analysis , Graft Survival/physiology , Immunosuppressive Agents/therapeutic use , Liver Transplantation/immunology , Liver Transplantation/pathology , Models, Animal , SwineABSTRACT
La causa más frecuente de hipertensión portal segmentaria es la trombosis aislada de la vena esplénica, generalmente asociada a pancreatitis crónica o a cáncer de páncreas. Presentamos el caso de un paciente con episodios repetidos de hemorragia digestiva alta por varices esofagogástricas secundarias a hipertensión portal segmentaria producidos por la compresión de un quiste verdadero de páncreas sobre la vena esplénica, lo que constituye una causa no descrita hasta el momento. La esplenectomía más pancreatectomía distal realizada reduce el flujo venoso de las colaterales proporcionando la curación en más del 90 por ciento de los casos (AU)
