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KMID : 0361120070210020188
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Korean Journal of Transplantation
2007 Volume.21 No. 2 p.188 ~ p.195
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Patterns and Treatment of the Surgical Complications following Living Donor Liver Transplantation.
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Hwang Shin
Lee Sung-Gyu
Ahn Chul-Soo
Kim Ki-Hun
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
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Abstract
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Living donor liver transplantation has definite demerits vulnerable to various surgical complications because the anatomy of the donor liver should be securely shared to ensure both donor safety and graft liver reconstruction. Major surgical complications can be classified into 3 types as intraabdominal bleeding, vascular anastomotic stenosis, and biliary complication. The sources of intraabdominal bleeding include the right inferior phrenic artery, right adrenal, graft liver cut surface, intrahepatic pseudoaneurysm, splenic artery aneurysm, hepatic artery anastomosis leak, and bowel anastomosis site. Radiologic intervention has been attempted for diagnostic and therapeutic intentions. There are several obligatory indications requiring emergency laparotomy for bleeding control. Significant stenosis can occur at every vascular anastomosis site of the liver graft. Metallic wall stents can be used to treat the anastomotic stenosis at the portal vein, hepatic vein and even hepatic artery. Biliary complication is the most common complication. Bile leak from the nastomotic site is often associated with serious infectious complication and subsequent stenosis. Biliary stenosis is usually not fatal, but often makes the quality of life deteriorate for a long time because it requires repeated treatment procedures. Bile leak at the graft liver cut surface is not common unless there is a technical fault during donor hepatectomy. The principle to cope with these surgical complications is to treat them in time and aggressively after consideration of the underlying causes and available treatment modalities.
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KEYWORD
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Living donor liver transplantation, Complication, Bleeding, Stenosis, Leak
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