Limits...
Causes of arterial bleeding after living donor liver transplantation and the results of transcatheter arterial embolization.

Kim JH, Ko GY, Yoon HK, Song HY, Lee SG, Sung KB - Korean J Radiol (2004 Jul-Sep)

Bottom Line: In the case of arterial bleeding after LDLT, percutaneous procedure-related hemorrhages were as common as surgery-related hemorrhages.There were technical difficulties in using TAE for the treatment of hepatic arterial bleeding.However, in the other locations, TAE seems to be safe and effective for the control of arterial bleeding in LDLT recipients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Inha University, College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To analyze the causes of arterial bleeding after living donor liver transplantation (LDLT) and to evaluate the efficacy of transcatheter arterial embolization (TAE).

Materials and methods: Forty-two sessions of conventional arteriography were performed in 32 of the 195 patients who underwent LDLT during the past 2 years. This was done in search of bleeding foci of arterial origin. TAE was performed with microcoils or gelatin sponge particles. The causes of arterial bleeding, the technical and clinical success rates of TAE and the complications were retrospectively evaluated.

Result: Forty-two bleeding foci of arterial origin were identified on 30 sessions of arteriography in 21 patients. The most common cause of bleeding was percutaneous procedures in 40% of the patients (17 of the 42 bleeding foci) followed by surgical procedures in 36% (15/42). The overall technical and clinical success rates of TAE were 21 (70%) and 20 (67%) of the 30 sessions, respectively. The overall technical success rate of TAE for the treatment of bleeding from the hepatic resection margin, hepatic artery anastomotic site and hepaticojejunostomy was only 18% (2/11), whereas for the treatment of bleeding in the other locations the technical and clinical success rates of TAE were 100% and 95%, respectively. No procedure-related major complications occurred.

Conclusion: In the case of arterial bleeding after LDLT, percutaneous procedure-related hemorrhages were as common as surgery-related hemorrhages. There were technical difficulties in using TAE for the treatment of hepatic arterial bleeding. However, in the other locations, TAE seems to be safe and effective for the control of arterial bleeding in LDLT recipients.

Show MeSH

Related in: MedlinePlus

A 47-year-old woman with arterial bleeding through a Jackson-Pratt drain.A. Right 10th intercostal arteriogram shows extravasation of contrast media (arrow).B. Right 10th intercostal artery was embolized with gelfoam particles and microcoils. After embolization, the stain disappeared. The patient clinically improved.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2698158&req=5

Figure 2: A 47-year-old woman with arterial bleeding through a Jackson-Pratt drain.A. Right 10th intercostal arteriogram shows extravasation of contrast media (arrow).B. Right 10th intercostal artery was embolized with gelfoam particles and microcoils. After embolization, the stain disappeared. The patient clinically improved.

Mentions: TAE was technically successful in 33 of the 42 foci of active arterial bleeding (Table 1) (Figs. 1, 2). However, TAE failed in the remaining 9 foci of active arterial bleeding, due to technically difficult superselection of the corresponding bleeding artery or the potential high risk associated with TAE (Fig. 3). These bleeding foci consisted of hepatic artery anastomotic sites (n=2), hepatic resection margins (n=4) and hepaticojejunostomies (n=3), and they were treated by surgery.


Causes of arterial bleeding after living donor liver transplantation and the results of transcatheter arterial embolization.

Kim JH, Ko GY, Yoon HK, Song HY, Lee SG, Sung KB - Korean J Radiol (2004 Jul-Sep)

A 47-year-old woman with arterial bleeding through a Jackson-Pratt drain.A. Right 10th intercostal arteriogram shows extravasation of contrast media (arrow).B. Right 10th intercostal artery was embolized with gelfoam particles and microcoils. After embolization, the stain disappeared. The patient clinically improved.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698158&req=5

Figure 2: A 47-year-old woman with arterial bleeding through a Jackson-Pratt drain.A. Right 10th intercostal arteriogram shows extravasation of contrast media (arrow).B. Right 10th intercostal artery was embolized with gelfoam particles and microcoils. After embolization, the stain disappeared. The patient clinically improved.
Mentions: TAE was technically successful in 33 of the 42 foci of active arterial bleeding (Table 1) (Figs. 1, 2). However, TAE failed in the remaining 9 foci of active arterial bleeding, due to technically difficult superselection of the corresponding bleeding artery or the potential high risk associated with TAE (Fig. 3). These bleeding foci consisted of hepatic artery anastomotic sites (n=2), hepatic resection margins (n=4) and hepaticojejunostomies (n=3), and they were treated by surgery.

Bottom Line: In the case of arterial bleeding after LDLT, percutaneous procedure-related hemorrhages were as common as surgery-related hemorrhages.There were technical difficulties in using TAE for the treatment of hepatic arterial bleeding.However, in the other locations, TAE seems to be safe and effective for the control of arterial bleeding in LDLT recipients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Inha University, College of Medicine, Seoul, Korea.

ABSTRACT

Objective: To analyze the causes of arterial bleeding after living donor liver transplantation (LDLT) and to evaluate the efficacy of transcatheter arterial embolization (TAE).

Materials and methods: Forty-two sessions of conventional arteriography were performed in 32 of the 195 patients who underwent LDLT during the past 2 years. This was done in search of bleeding foci of arterial origin. TAE was performed with microcoils or gelatin sponge particles. The causes of arterial bleeding, the technical and clinical success rates of TAE and the complications were retrospectively evaluated.

Result: Forty-two bleeding foci of arterial origin were identified on 30 sessions of arteriography in 21 patients. The most common cause of bleeding was percutaneous procedures in 40% of the patients (17 of the 42 bleeding foci) followed by surgical procedures in 36% (15/42). The overall technical and clinical success rates of TAE were 21 (70%) and 20 (67%) of the 30 sessions, respectively. The overall technical success rate of TAE for the treatment of bleeding from the hepatic resection margin, hepatic artery anastomotic site and hepaticojejunostomy was only 18% (2/11), whereas for the treatment of bleeding in the other locations the technical and clinical success rates of TAE were 100% and 95%, respectively. No procedure-related major complications occurred.

Conclusion: In the case of arterial bleeding after LDLT, percutaneous procedure-related hemorrhages were as common as surgery-related hemorrhages. There were technical difficulties in using TAE for the treatment of hepatic arterial bleeding. However, in the other locations, TAE seems to be safe and effective for the control of arterial bleeding in LDLT recipients.

Show MeSH
Related in: MedlinePlus