Diaphragm rupture in a liver transplant patient under chronic immunosuppressive therapy with sirolimus: rare complication after liver transplantation

2010 ◽  
Vol 63 (1) ◽  
pp. 51-53 ◽  
Author(s):  
Anna Rossetto ◽  
Umberto Baccarani ◽  
Gian Luigi Adani ◽  
Dario Lorenzin ◽  
Vittorio Bresadola ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Immunosuppressive Therapy ◽  
Transplant Patient ◽  
Rare Complication ◽  
Liver Transplant Patient ◽  
Diaphragm Rupture

scholarly journals Diaphragm rupture in a liver transplant patient receiving chronic immunosuppressive therapy with sirolimus

2010 ◽  
Vol 16 (10) ◽  
pp. 1220-1220 ◽  
Author(s):  
Gian Luigi Adani ◽  
Anna Rossetto ◽  
Vittorio Bresadola ◽  
Umberto Baccarani
Keyword(s):  
Liver Transplant ◽  
Immunosuppressive Therapy ◽  
Transplant Patient ◽  
Liver Transplant Patient ◽  
Diaphragm Rupture

scholarly journals A220 AN UNEXPECTED CAUSE OF ACUTE JAUNDICE IN A POST-TRANSPLANT PATIENT

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 253-254
Author(s):  
K W Wong ◽  
J Silverman
Keyword(s):  
Liver Transplantation ◽  
Abdominal Pain ◽  
Liver Transplant ◽  
Diaphragmatic Hernia ◽  
Biliary Obstruction ◽  
Transplant Patient ◽  
Hepatic Duct ◽  
Liver Transplant Patient ◽  
Unique Case ◽  
Post Transplant

Abstract Background Complications post liver transplantation are common. These may include thromboses, primary graft nonfunction, biliary complications, chylothorax, infection, and rejection. Hepaticojejunostomy with Roux-en-Y limb is a common technique for pediatric liver transplantation. Complications of hepaticojejunostomy include small bowel obstruction due to incarceration of the Roux-en-Y limb within an internal hernia. Acquired diaphragmatic hernia has previously been reported in liver transplant patients. Here we present a unique case of acute biliary obstruction secondary to incarceration of a Roux limb within an acquired diaphragmatic hernia. Aims To describe a unique case of incarcerated Roux-en-Y limb in a diaphragmatic hernia leading to acute jaundice in a pediatric liver transplant patient. Methods Retrospective chart review and case review with the surgical and medical teams. Results A 14 month old girl with unresectable hepatoblastoma received a living donor, left lateral segment liver transplant using standard venous reconstruction, microvascular plastics arterial reconstruction, and the recipient common hepatic duct was anastomosed to the donor left hepatic duct. Serial ultrasounds showed persistent intrahepatic duct dilatation with cholestasis. Given the concern of biliary obstruction, 10 days post-transplant, she underwent repeat laparotomy and was found to have a dilated common bile duct with a proximal obstruction. A Roux-en-Y hepaticojejunostomy was performed to establish adequate biliary drainage. Three months post-transplant she developed lung metastases that required wedge resection and chemotherapy. 7 months post-transplant, while admitted for routine chemotherapy she acutely developed jaundice, pruritus, and transaminitis. Liver ultrasound showed an apparent fluid collection at the cut surface of the liver and biliary dilatation. Extrinsic compression of the biliary tree was suspected, and so a percutaneous biliary drain was placed to drain the collection and decompress the biliary system. Despite improvement in the transaminitis and cholestasis, several days later, she developed severe abdominal pain and associated grunting respirations. An MRI with MRCP to reassess the previous findings and rule out a new intraabdominal cause for her symptoms was completed and unexpectedly showed herniation of her Roux-en-Y limb into a diaphragmatic hernia. She had urgent diaphragmatic hernia repair with reduction of the incarcerated bowel loop, with resolution of her pain and jaundice. Conclusions Post liver transplant Roux-en-Y herniation is uncommon, but can occur with internal hernias and in diaphragmatic hernias. This uncommon complication should be considered for the post liver transplant patient with hepaticojejunostomy in the setting of acute jaundice, particularly if accompanied by acute onset abdominal pain and/or increased work of breathing. Funding Agencies None

scholarly journals A staged approach for a lung-liver transplant patient usingex vivoreconditioned lungs first followed by an urgent liver transplantation

2014 ◽  
Vol 28 (1) ◽  
pp. 129-133 ◽  
Author(s):  
Caroline Van De Wauwer ◽  
Erik A. M. Verschuuren ◽  
George D. Nossent ◽  
Wim van der Bij ◽  
Inez J. den Hamer ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Transplant ◽  
Transplant Patient ◽  
Liver Transplant Patient ◽  
Staged Approach

Predictors of Liver Transplant Patient Survival

2016 ◽  
Vol 27 (1) ◽  
pp. 98-106 ◽  
Author(s):  
Lisiane Pruinelli ◽  
Karen A. Monsen ◽  
Cynthia R. Gross ◽  
David M. Radosevich ◽  
György J. Simon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Large Scale ◽  
Transplant Patient ◽  
Patient Survival ◽  
The United States ◽  
Liver Transplant Patient ◽  
Holistic View ◽  
Donor Liver Transplantation

Objective: Liver transplantation is a costly and risky procedure, representing 25 050 procedures worldwide in 2013, with 6729 procedures performed in the United States in 2014. Considering the scarcity of organs and uncertainty regarding prognosis, limited studies address the variety of risk factors before transplantation that might contribute to predicting patient’s survival and therefore developing better models that address a holistic view of transplant patients. This critical review aimed to identify predictors of liver transplant patient survival included in large-scale studies and assess the gap in risk factors from a holistic approach using the Wellbeing Model and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Data Source: Search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed from the 1980s to July 2014. Study Selection: Original longitudinal large-scale studies, of 500 or more subjects, published in English, Spanish, or Portuguese, which described predictors of patient survival after deceased donor liver transplantation. Data Extraction: Predictors were extracted from 26 studies that met the inclusion criteria. Data Synthesis: Each article was reviewed and predictors were categorized using a holistic framework, the Wellbeing Model (health, community, environment, relationship, purpose, and security dimensions). Conclusions: The majority (69.7%) of the predictors represented the Wellbeing Model Health dimension. There were no predictors representing the Wellbeing Dimensions for purpose and relationship nor emotional, mental, and spiritual health. This review showed that there is rigorously conducted research of predictors of liver transplant survival; however, the reported significant results were inconsistent across studies, and further research is needed to examine liver transplantation from a whole-person perspective.

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