Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation
A 69-year-old man underwent liver transplantation with a deceased donor for cirrhosis secondary to steatohepatitis. The arterial anastomosis was performed between the celiac trunk of the donor and the hepatic artery of the recipient. In the second postoperative month, he developed abdominal pain and...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2024
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/43452 |
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I10-R327-article-43452 |
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| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
liver transplation aneurysm false hepatic artery transplante de hígado aneurisma falso arteria hepática transplante de fígado aneurisma falso arteria hepática |
| spellingShingle |
liver transplation aneurysm false hepatic artery transplante de hígado aneurisma falso arteria hepática transplante de fígado aneurisma falso arteria hepática Gasque, Rodrigo Antonio Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan ., . Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| topic_facet |
liver transplation aneurysm false hepatic artery transplante de hígado aneurisma falso arteria hepática transplante de fígado aneurisma falso arteria hepática |
| author |
Gasque, Rodrigo Antonio Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan ., . Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan |
| author_facet |
Gasque, Rodrigo Antonio Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan ., . Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan |
| author_sort |
Gasque, Rodrigo Antonio |
| title |
Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| title_short |
Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| title_full |
Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| title_fullStr |
Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| title_full_unstemmed |
Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| title_sort |
pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation |
| description |
A 69-year-old man underwent liver transplantation with a deceased donor for cirrhosis secondary to steatohepatitis. The arterial anastomosis was performed between the celiac trunk of the donor and the hepatic artery of the recipient. In the second postoperative month, he developed abdominal pain and abnormal liver function tests. MRI angiography and subsequent digital angiography confirmed a 50 x 60 mm hepatic artery pseudoaneurysm (PAH) with dilation of the bile duct and bilomas in both hepatic lobes. Endovascular treatment could not be performed due to the absence of contrast passage to the intrahepatic branches during angiography. A surgical ligation and resection of the PAH that compromised both hepatic arteries was chosen. The primary anastomosis was not viable because it was not possible to identify a viable proximal end or ostium. Given the ischemic compromise of the bile duct, an exception route for re-transplantation was requested from INCUCAI, thus entering the waiting list and accessing a new graft 30 days later. His subsequent evolution was favorable. Now he's asymptomatic under follow-up after 9 years of the liver re-transplantation. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2024 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/43452 |
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2025-02-05T22:05:30Z |
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I10-R327-article-434522024-12-13T15:13:20Z Pseudoaneurysm of the hepatic artery as a cause of liver re-transplantation Pseudoaneurisma de la arteria hepática como causa de re-trasplante hepático Pseudoaneurisma da artéria hepática como causa de retransplante de fígado Gasque, Rodrigo Antonio Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan ., . Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan Cervantes, José Gabriel Chahdi Beltrame, Magalí Lenz Virreira, Marcelo Enrique Quiñonez, Emilio Gastón Mattera, Francisco Juan liver transplation aneurysm false hepatic artery transplante de hígado aneurisma falso arteria hepática transplante de fígado aneurisma falso arteria hepática A 69-year-old man underwent liver transplantation with a deceased donor for cirrhosis secondary to steatohepatitis. The arterial anastomosis was performed between the celiac trunk of the donor and the hepatic artery of the recipient. In the second postoperative month, he developed abdominal pain and abnormal liver function tests. MRI angiography and subsequent digital angiography confirmed a 50 x 60 mm hepatic artery pseudoaneurysm (PAH) with dilation of the bile duct and bilomas in both hepatic lobes. Endovascular treatment could not be performed due to the absence of contrast passage to the intrahepatic branches during angiography. A surgical ligation and resection of the PAH that compromised both hepatic arteries was chosen. The primary anastomosis was not viable because it was not possible to identify a viable proximal end or ostium. Given the ischemic compromise of the bile duct, an exception route for re-transplantation was requested from INCUCAI, thus entering the waiting list and accessing a new graft 30 days later. His subsequent evolution was favorable. Now he's asymptomatic under follow-up after 9 years of the liver re-transplantation. Hombre de 69 años de edad sometido a trasplante hepático con donante cadavérico por cirrosis secundaria a esteatohepatitis. La anastomosis arterial fue realizada entre el tronco celíaco del donante y la arteria hepática del receptor. Al segundo mes postoperatorio desarrolló dolor abdominal y alteración en el hepatograma. La angio-RMN y posterior angiografía digital confirmaron un pseudoaneurisma de la arteria hepática (PAH) de 50 x 60 mm con dilatación de la vía biliar y bilomas en ambos lóbulos hepáticos. No se pudo realizar tratamiento endovascular por la ausencia de pasaje de contraste a las ramas intrahepáticas durante la angiografía. Se optó por la ligadura y resección quirúrgica del PAH que comprometía ambas arterias hepáticas. La anastomosis primaria no fue viable debido a que no se logró identificar cabo proximal u ostium viable. Ante el compromiso isquémico de la vía biliar, se solicitó vía de excepción para re-trasplante al INCUCAI ingresando así en lista de espera y accediendo a un nuevo injerto 30 días después. Su evolución posterior fue favorable encontrándose asintomático bajo seguimiento durante 9 años luego del re-trasplante. Homem de 69 anos foi submetido a transplante de fígado com doador cadáver por cirrose secundária a esteatohepatite. A anastomose arterial foi realizada entre o tronco celíaco do doador e a artéria hepática do receptor. No segundo mês de pós-operatório, desenvolveu dor abdominal e alterações nas provas de função hepática. A angiografia por ressonância magnética e subsequente angiografia digital confirmaram pseudoaneurisma de artéria hepática (HAP) de 50 x 60 mm com dilatação do ducto biliar e bilomas em ambos os lobos hepáticos. O tratamento endovascular não pôde ser realizado devido à ausência de passagem de contraste para os ramos intra-hepáticos durante a angiografia. Optou-se pela ligadura cirúrgica e ressecção da HAP que comprometia ambas as artérias hepáticas. A anastomose primária não foi viável porque não foi possível identificar extremidade proximal ou óstio viável. Dado o comprometimento isquêmico da via biliar, foi solicitada ao INCUCAI via excepcional para retransplante, entrando assim em lista de espera e acessando novo enxerto 30 dias depois. Sua evolução posterior foi favorável e permaneceu assintomático sob acompanhamento por 9 anos após retransplante. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2024-12-13 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/43452 10.31053/1853.0605.v81.n4.43452 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 81 No. 4 (2024); 842-851 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 81 Núm. 4 (2024); 842-851 Revista da Faculdade de Ciências Médicas de Córdoba; v. 81 n. 4 (2024); 842-851 1853-0605 0014-6722 10.31053/1853.0605.v81.n4 spa https://revistas.unc.edu.ar/index.php/med/article/view/43452/47627 https://revistas.unc.edu.ar/index.php/med/article/view/43452/47075 Derechos de autor 2024 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |