RÉSUMÉ
In order to ameliorate early recovery after liver transplantation a reduction of invasiveness of the abdominal incision has been tested and compared with more extended incisions. This approach named "minitransplant procedure" resulted in better early and late outcome results irrespective of preoperative patients' risk factors as previous upper abdominal surgery, Body Mass Index and Model of End Stage Liver Disease score.
Sujet(s)
Transplantation hépatique/méthodes , Adulte , Maladie du foie en phase terminale/chirurgie , Humains , Indice de gravité de la maladie , Résultat thérapeutiqueRÉSUMÉ
Intravenous administration of immunoglobulin (IVIG), rarely, can be the cause of acute renal failure (ARF). Such adverse reaction can occur almost exclusively when using preparations containing saccharose. The use of anti-HBV immunoglobulin (HBIG) is an effective prophylactic strategy against graft infection following liver transplantation. We report a case of ARF following prophylactic intravenous administration of HBIG in a liver transplanted patient. Anti-HBV immunoglobulin containing saccharose should be avoided in the perioperative period, because of the concomitance with other risk factors for ARF.
Sujet(s)
Atteinte rénale aigüe/étiologie , Immunoglobulines par voie veineuse/administration et posologie , Transplantation hépatique , Adulte , Antiviraux/usage thérapeutique , Créatinine/sang , Femelle , Ganciclovir/usage thérapeutique , Humains , Cirrhose du foie/complications , Facteurs de risque , Facteurs tempsRÉSUMÉ
Little is known about incidence and risk factors for incisional hernia after liver transplantation (OLT). More frequently this problem occurs at the junction of midline and transverse incisions. We prospectively and consecutively used three different types of abdominal incisions in 47 OLTs. The results were compared in order to identify the type of incision and risk factors that determine herniae after OLT. The overall incidence was 17%. It occurred in 6 out of 19 patients (31.3%) with a transverse and right subcostal both with upper midline incision versus 2 out of 26 patients (7.7%) with only a right subcostal incision. In conclusion, a subcostal incision is sufficient to perform OLT and reduce hernia incidence after OLT.
Sujet(s)
Transplantation hépatique/méthodes , Études de faisabilité , Hernie/épidémiologie , Hernie/étiologie , Hernie/prévention et contrôle , Humains , Incidence , Complications postopératoires/épidémiologie , Complications postopératoires/prévention et contrôle , Reproductibilité des résultatsRÉSUMÉ
Caval anastomosis in liver transplantation has been modified to avoid outflow complications. Classic cava replacement is rarely indicated; most liver transplantation teams use a piggy-back (PB) technique. At the start of our liver transplantation program, we opted for a latero-lateral (L-L) caval anastomosis. In our prospective experience, the L-L caval anastamosis was safe and feasible in all 24 adult patients. No vascular complications occurred. Graft and patient survival rates were both 96% at 11 months follow-up.
