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Incidence and management of postoperative abdominal bleeding after liver transplantation.

Abstract：

PURPOSE:To assess the incidence and management of postoperative abdominal bleeding after orthotopic liver transplantation (OLT) and to identify risk factors for abdominal bleeding. METHODS:We retrospectively reviewed the medical records of 1039 patients who underwent OLT at our institution from January 2008 to December 2010 seeking to identify subjects with posttransplantation abdominal bleeding, defined as any hemorrhage requiring radiologic intervention or laparotomy within the first month. RESULTS:Among the 1039 patients, 94 (9%) showed abdominal bleeding, occurring at a mean of 6.1 days (range, day 1 to 21 days). Active bleeding was controlled by endovascular interventional techniques (n = 37; 39%), by surgical ligation or vascular reconstruction (n = 43; 46%), or by sequential combinations of endovascular intervention and surgery (n = 14; 15%). The most frequent bleeding sites for radiologic intervention were the right inferior phrenic artery (n = 14), right and left epigastric arteries (n = 7), intercostal artery (n = 5) and right renal capsular artery (n = 4). The most frequent bleeding sites requiring laparotomy were the hepatic artery (n = 9), diaphragm (n = 8), inferior vena cava (n = 5), abdominal drain insertion site (n = 4), portal vein anastomosis site (n = 4), abdominal wall (n = 3), liver graft cut surface (n = 3), hilar plate (n = 3), and greater omentum (n = 3). Bleeding episodes were associated with greater patient age and increased intraoperative blood loss. CONCLUSIONS:The risk of bleeding from coagulopathy and iatrogenic injury is high during the early posttransplantation period. This risk of bleeding can be minimized by meticulous surgical dissection and bleeding control.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Jung SW,Hwang S,Namgoong JM,Yoon SY,Park CS,Park YH,Lee HJ,Park HW,Park GC,Jung DH,Song GW,Ha TY,Ahn CS,Kim KH,Moon DB,Ko GY,Sung KB,Lee SG

doi

10.1016/j.transproceed.2012.01.011

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

765-8

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(12)00045-0

journal_volume

44

pub_type

杂志文章

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