back table arterial reconstruction in liver transplantation single centre experience l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
BACK-TABLE ARTERIAL RECONSTRUCTION IN LIVER TRANSPLANTATION: SINGLE CENTRE EXPERIENCE PowerPoint Presentation
Download Presentation
BACK-TABLE ARTERIAL RECONSTRUCTION IN LIVER TRANSPLANTATION: SINGLE CENTRE EXPERIENCE

Loading in 2 Seconds...

play fullscreen
1 / 15

BACK-TABLE ARTERIAL RECONSTRUCTION IN LIVER TRANSPLANTATION: SINGLE CENTRE EXPERIENCE - PowerPoint PPT Presentation


  • 614 Views
  • Uploaded on

BACK-TABLE ARTERIAL RECONSTRUCTION IN LIVER TRANSPLANTATION: SINGLE CENTRE EXPERIENCE Istituto di Chirurgia Sperimentale, dei Trapianti e Cardiovascolare Università degli Studi di Milano Unità Operativa Complessa: Centro Trapianto di Fegato e Polmone Ospedale Maggiore IRCCS

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'BACK-TABLE ARTERIAL RECONSTRUCTION IN LIVER TRANSPLANTATION: SINGLE CENTRE EXPERIENCE' - Faraday


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
back table arterial reconstruction in liver transplantation single centre experience
BACK-TABLE ARTERIAL RECONSTRUCTION IN LIVER TRANSPLANTATION: SINGLE CENTRE EXPERIENCE

Istituto di Chirurgia Sperimentale, dei Trapianti e Cardiovascolare

Università degli Studi di Milano

Unità Operativa Complessa: Centro Trapianto di Fegato e Polmone

Ospedale Maggiore IRCCS

Direttore Prof. L. R. Fassati

Ernesto MELADA,

Umberto MAGGI, Giorgio ROSSI, Lucio CACCAMO, Stefano GATTI, Giovanni PAONE, Paolo REGGIANI, Emilietta BRIGATI,

Luigi Rainero FASSATI

11th ANNUAL INTERNATIONAL CONGRESS - I.L.T.S - LOS ANGELES JULY 20-23, 2005

slide2

AIM OF STUDY

  • To evaluate the rate of arterial variants of hepatic supply and of different types of variants
  • To review our arterial reconstructions in LT
  • To test a relationship between arterial reconstructions and hepatic artery thrombosis / biliary complications
  • To test a relationship between arterial reconstructions on back table and early and late graft survival after LT, both in adult and in pediatric recipients
slide4

PATIENTS AND METHODS

  • We reviewed our series of LT and we recorded:
  • Arterial variants in donors, and reconstructions performed on back table
  • Then, according to arterial reconstructions, and separately considering pediatric and adult recipients, we reviewed:
  • grafts that underwent hepatic artery thrombosis
  • grafts that underwent major - requiring open surgery - biliary complications (excluding partial grafts)
  • graft survival (in Whole grafts, excluding Retransplantations)
slide6

RHA: right hepatic artery; LHA: left hepatic artery; SMA: superior mesenteric artery; CT: celiac trunk

slide10

Hepatic artery thrombosis

1 vs 2: ns. 2 vs 3: ns 2 vs 4: 0.003 2 vs 5: 0.000 2 vs 6: ns

7 vs 9: ns

Wo = Without

slide11

Wo = Without W = With

WL = Whole Liver

3 vs 4: ns.

slide12

Arterial reconstructions and

Graft actuarial survival in adults (WG, no retx)

Log rank test: ns

slide13

Graft actuarial survival in pediatrics

(WG, no retx)

Log rank test: ns

conclusions i
Conclusions I
  • The rate of arterial anatomic variants in liver supply is quite high (22%) but only 9% of grafts need an arterial reconstruction
  • Most frequent arterial variant (80%) needing reconstruction is RHA from SMA. The most frequent reconstruction is RHASA (43%).
slide15

Conclusions II

  • Arterial reconstructions due to hepatic arterial variants don’t undergo statistically significant higher rates of HAT (6%); therefore a more strict arterial surveillance for HAT is not mandatory in grafts with arterial reconstructions.
  • Aortic conduits have the highest rate of thrombosis (13%) and need surveillance.
  • The rate of major biliary complications is not influenced by arterial reconstructions.
  • Graft survival at 1-3-5-10 years after LT is not influenced with statistically significance by arterial reconstructions.

u.maggi@tiscali.it