Treatment of Life-Threatening Hyperkalemia Using Hemoconcentration in Parallel to Venovenous Bypass During Orthotopic Liver Transplantation

Postoperative delayed diaphragmatic hernia (DH) is a rare and uncommon event after adult orthotopic liver transplantation (OLT), which however could be potentially life-threatening complication, especially in the absence of early and correct diagnosis and appropriate surgical treatment. We present a case of 48 year-old male with left diaphragmatic herniation of left part of transverse colon, who thirty nine months before underwent OLT with right-sided allograft implantation and which was recently successfully managed by open abdominal approach in our institution. The postoperative course was uneventful and he was discharged at the 8th day after surgery. Our case illustrates, that delayed DH after the OLT in adults could be a new problem, which affect transplant recipients with long-term follow-up period. Hence, we consider, that once the diagnosis of DH is confirmed, the patient should be operated immediately, in order to avoid the possible life-threatening complications.

Download Full-text

Life-threatening abo-mediated hemolysis after cadaveric orthotopic liver transplantation

Transplantation Journal ◽

10.1097/00007890-200207270-00024 ◽

2002 ◽

Vol 74 (2) ◽

pp. 285-286 ◽

Cited By ~ 5

Author(s):

W. Y. Au ◽

C. M. Lo ◽

S. T. Fan ◽

C. L. Liu ◽

C. C. K. Lam

Keyword(s):

Liver Transplantation ◽

Orthotopic Liver Transplantation ◽

Life Threatening

Download Full-text

Postoperative kidney injury does not decrease survival after liver transplantation

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502012001100010 ◽

2012 ◽

Vol 27 (11) ◽

pp. 802-808 ◽

Cited By ~ 2

Author(s):

Olival Cirilo Lucena da Fonseca-Neto ◽

Luiz Eduardo Correia Miranda ◽

Thales Paulo Batista ◽

Bernardo David Sabat ◽

Paulo Sérgio Vieira de Melo ◽

...

Keyword(s):

Liver Transplantation ◽

Acute Kidney Injury ◽

Orthotopic Liver Transplantation ◽

Multivariate Analyses ◽

Patient Survival ◽

Kidney Injury ◽

Term Survival ◽

Venovenous Bypass

PURPOSE: To explore the effect of acute kidney injury (AKI) on long-term survival after conventional orthotopic liver transplantation (OLT) without venovenous bypass (VVB). METHODS: A retrospective cohort study was carried out on 153 patients with end-stage liver diseases transplanted by the Department of General Surgery and Liver Transplantation of the University of Pernambuco, from August, 1999 to December, 2009. The Kaplan-Meier survival estimates and log-rank test were applied to explore the association between AKI and long-term patient survival, and multivariate analyses were applied to control the effect of other variables. RESULTS: Over the 12.8-year follow-up, 58.8% patients were alive with a median follow-up of 4.5-year. Patient 1-, 2-, 3- and 5-year survival were 74.5%, 70.6%, 67.9% and 60.1%; respectively. Early postoperative mortality was poorer amongst patients who developed AKI (5.4% vs. 20%, p=0.010), but long-term 5-year survival did not significantly differed between groups (51.4% vs. 65.3%; p=0.077). After multivariate analyses, AKI was not significantly related to long-term survival and only the intraoperative transfusion of red blood cells was significantly related to this outcome (non-adjusted Exp[b]=1.072; p=0.045). CONCLUSION: The occurrence of postoperative acute kidney injury did not independently decrease patient survival after orthotopic liver transplantation without venovenous bypass in this data from northeast Brazil.

Download Full-text