Transcapsular arterial neovascularization of liver transplants increases the risk of intraoperative bleeding during retransplantation.
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Transcapsular arterial neovascularization of liver transplants increases the risk of intraoperative bleeding during retransplantation. / Herrmann, Jochen; Herden, Uta; Ganschow, Rainer; Petersen, Kay U; Schmid, Felix; Derlin, Thorsten; Koops, Andreas; Peine, Sven; Sterneck, Martina; Fischer, Lutz; Helmke, Knut.
In: TRANSPL INT, Vol. 26, No. 4, 4, 2013, p. 419-427.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Transcapsular arterial neovascularization of liver transplants increases the risk of intraoperative bleeding during retransplantation.
AU - Herrmann, Jochen
AU - Herden, Uta
AU - Ganschow, Rainer
AU - Petersen, Kay U
AU - Schmid, Felix
AU - Derlin, Thorsten
AU - Koops, Andreas
AU - Peine, Sven
AU - Sterneck, Martina
AU - Fischer, Lutz
AU - Helmke, Knut
N1 - © 2013 The Authors Transplant International © 2013 European Society for Organ Transplantation. Published by Blackwell Publishing Ltd.
PY - 2013
Y1 - 2013
N2 - Arterial neovascularization of liver grafts can be a source of significant blood loss during retransplantation. This study evaluated the effect of transcapsular arterial neovascularization on intraoperative blood loss during retransplantation and long-term follow-up. Eleven consecutive patients with transcapsular arterial neovascularization (seven male, four female; nine children, two adults; mean age 12.3 ± 16.3 years) and the same number of matched control patients were analysed. Blood loss was calculated based on transfusion requirements. The volume of transfused units of red blood cells per kilogram bodyweight until hepatectomy and during the entire procedure was significantly higher in patients with neovascularization than in control patients (0.32 ± 0.21 vs. 0.14 ± 0.11, and 0.94 ± 0.83 vs. 0.36 ± 0.38 respectively; P-values 0.027). Neovascularization was associated with extensive intra-abdominal adhesions and a longer operating time until hepatectomy (175.6 ± 52.1 min vs. 124.3 ± 34.9 min, P-value 0.015). Postoperative revisions were performed more frequently in patients with neovessels. Graft survival did not differ between groups. Assessment for transcapsular arterial neovascularization should be included in preoperative Doppler ultrasound protocols to identify patients at risk of a complicated intra- and postoperative course in case of retransplantation.
AB - Arterial neovascularization of liver grafts can be a source of significant blood loss during retransplantation. This study evaluated the effect of transcapsular arterial neovascularization on intraoperative blood loss during retransplantation and long-term follow-up. Eleven consecutive patients with transcapsular arterial neovascularization (seven male, four female; nine children, two adults; mean age 12.3 ± 16.3 years) and the same number of matched control patients were analysed. Blood loss was calculated based on transfusion requirements. The volume of transfused units of red blood cells per kilogram bodyweight until hepatectomy and during the entire procedure was significantly higher in patients with neovascularization than in control patients (0.32 ± 0.21 vs. 0.14 ± 0.11, and 0.94 ± 0.83 vs. 0.36 ± 0.38 respectively; P-values 0.027). Neovascularization was associated with extensive intra-abdominal adhesions and a longer operating time until hepatectomy (175.6 ± 52.1 min vs. 124.3 ± 34.9 min, P-value 0.015). Postoperative revisions were performed more frequently in patients with neovessels. Graft survival did not differ between groups. Assessment for transcapsular arterial neovascularization should be included in preoperative Doppler ultrasound protocols to identify patients at risk of a complicated intra- and postoperative course in case of retransplantation.
KW - Adolescent
KW - Adult
KW - Blood Loss, Surgical
KW - Case-Control Studies
KW - Child
KW - Child, Preschool
KW - Female
KW - Humans
KW - Infant
KW - Liver Transplantation
KW - Male
KW - Middle Aged
KW - Neovascularization, Pathologic
KW - Reoperation
KW - Retrospective Studies
KW - Risk
U2 - 10.1111/tri.12062
DO - 10.1111/tri.12062
M3 - SCORING: Journal article
C2 - 23350918
VL - 26
SP - 419
EP - 427
JO - TRANSPL INT
JF - TRANSPL INT
SN - 0934-0874
IS - 4
M1 - 4
ER -