scholarly journals Emergency interventional endovascular treatment for early disorder of arterial blood flow in the liver graft

2021 ◽  
Vol 13 (4) ◽  
pp. 367-381
Author(s):  
B. B. Gegenava ◽  
S. A. Kurnosov ◽  
Ya. G. Moysyuk ◽  
N. N. Vetsheva ◽  
A. A. Ammosov
Keyword(s):  
Liver Transplantation ◽  
Hepatic Artery ◽  
Blood Supply ◽  
Liver Graft ◽  
Arterial Blood Supply ◽  
X Ray ◽  
Image Guided ◽  
Endovascular Interventions ◽  
Arterial Blood ◽  
Arterial Complications

Introduction. Liver transplantation is considered the most effective treatment for patients with end-stage liver disease. X-ray endovascular interventions show good results in the treatment of vascular complications after transplantation. The timing, indications and choice of treatment methods require clarification.Objective. To evaluate the safety and efficacy of emergency X-ray endovascular interventions for arterial complications in the early period after liver transplantation.Material and methods. In the period from October 2016 by July 2021, 88 liver transplants were performed. The graft was obtained from a posthumous donor in 75 cases, and from a living donor (right lobe of the liver) in 13 cases. Arterial complications were registered in 10 cases: thrombosis of the hepatic artery in 7 (8.0%), constriction in 3 (3.4%); 4 patients underwent retransplantation due to thrombosis. This analysis included 6 patients aged 27 to 51 years, including 4 men and 2 women. In the early postoperative period (0–14 days), according to laboratory parameters, ultrasound Doppler, and computed tomography with a contrast agent, an impairment of the arterial blood supply of the graft was revealed, for which the patients underwent emergency X-ray image-guided surgical endovascular interventions.Results. Restoration of adequate arterial blood supply to the liver graft was achieved in all six patients. At the time of this writing, the graft function and patency of the hepatic artery were preserved at follow-up periods of 6, 11, 12, 22 (in two patients), and 26 months with a median of 17 months. Four patients developed biliary complications that required surgical correction.Conclusion. X-ray image-guided endovascular interventions can be considered effective and relatively safe in the treatment of patients with arterial complications after liver transplantation. The period of graft arterial ischemia should be minimized as much as possible in order to prevent biliary complications.

Formation of Effective Collateral Circulation Following Excision of Hepatic Artery

1956 ◽  
Vol 184 (3) ◽  
pp. 589-592 ◽  
Author(s):  
N. C. Jefferson ◽  
M. I. Hassan ◽  
H. L. Popper ◽  
H. Necheles
Keyword(s):  
Hepatic Artery ◽  
Blood Supply ◽  
Collateral Circulation ◽  
Plastic Material ◽  
X Ray ◽  
Adequate Supply ◽  
Hepatic Arteries ◽  
Arterial Blood ◽  
Red Lead

The present work is an anatomical demonstration of the collateral blood supply which maintains the liver after acute interruption of the hepatic artery. This is demonstrated with x-ray films and corrosion specimens of the livers of dogs weeks to months following excision of the hepatic artery. The livers were injected with red lead suspension or with a plastic material. With both methods, we have demonstrated the development of adequate anastomoses within the liver between the phrenic and the hepatic arteries. The phrenic arteries had hypertrophied considerably and numerous good sized anastomoses with the hepatic arteries were present, allowing for an adequate supply of arterial blood to the liver and survival of the animal. In similar control experiments on normal dogs, the phrenic arteries were small, and insignificant anastomoses to the hepatic arteries were found.

Blocking of the Intrahepatic Blood Circulation. II

1956 ◽  
Vol 185 (1) ◽  
pp. 125-126
Author(s):  
H. L. Popper ◽  
N. C. Jefferson ◽  
H. Necheles
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Blood Supply ◽  
Blood Circulation ◽  
Plastic Medium ◽  
Arterial Blood Supply ◽  
Arterial Blood ◽  
Red Lead ◽  
The Media ◽  
Toxic Reactions

In previous work it was found that a relatively small collateral blood supply by the phrenic arteries mainly was adequate to maintain the liver following ligation of the hepatic artery and the portal vein. In order to demonstrate the pathways of the collaterals, normal dogs and dogs that had survived ligation of either the hepatic artery or the portal vein for some time were used. A plastic dissolved in acetone that gelled with water, or mineral oil, or red lead dye suspension, was used for injection. The acetone content of the plastic medium produced toxic reactions. The media were injected into branches of the intact portal vein or into the intact hepatic artery, or into the hepatic artery or the portal vein above the ligature. Blocking of the intrahepatic branches of the hepatic artery caused liver necrosis in every instance, while blocking of the intrahepatic branches of the portal vein was tolerated. Thus, blocking of branches of the hepatic artery demonstrates that the essential collateral arterial blood supply had been interrupted.

scholarly journals Collateral Arterial Blood Supply of the Liver after Hepatic Artery Ligation, Angiographic Study of Twenty Patients

1972 ◽  
Vol 175 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Ukrist Plengvanit ◽  
Orpan Chearanai ◽  
Kijja Sindiivananda ◽  
Direk Damrongsak ◽  
Sasiprapa Tuchinda ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Blood Supply ◽  
Hepatic Artery Ligation ◽  
Angiographic Study ◽  
Arterial Blood Supply ◽  
Artery Ligation ◽  
Arterial Blood

scholarly journals Arterial blood supply to the liver, celiac and mesenteric pool (literature review)

2021 ◽  
Vol 25 (2) ◽  
pp. 74-83
Author(s):  
N. A. Rubtsova ◽  
M. N. Pheduleev ◽  
Y. I. Nerestyuk ◽  
D. K. Khamidov ◽  
D. V. Sidorov ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Clinical Practice ◽  
Literature Review ◽  
Blood Vessels ◽  
Blood Supply ◽  
Vascular Anatomy ◽  
Arterial Blood Supply ◽  
Advantages And Disadvantages ◽  
Arterial Blood

Knowledge of the variant vascular anatomy of the celiac and mesenteric basin is of paramount importance in operative interventions in the hepatopancreatobiliary zone, stomach and duodenum, liver transplantation. The article presents various classifications of vessels of the celiac and mesenteric basin, created by the authors as a result of numerous studies using various techniques. The main advantages and disadvantages of the main classifications of blood vessels are considered, the features of application in clinical practice are given.

scholarly journals Providing Arterial Supply to the Liver Graft with Recipient Splenic Artery in Living Donor Liver Transplantation: Case Report

2020 ◽  
pp. 1-3
Author(s):  
Kaleem Ullah ◽  
Shams Uddin ◽  
Hala Izzu ◽  
Kaleem Ullah ◽  
Abdul Wahab Dogar ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Hepatic Artery ◽  
Splenic Artery ◽  
Surgical Techniques ◽  
Arterial Blood Flow ◽  
Liver Graft ◽  
Artery Dissection ◽  
Arterial Blood ◽  
Operative Recovery

Hepatic arterial reconstruction is an important step in graft implantation in liver transplant procedure. Hepatic arterial anastomosis always demands meticulous and highly skilled surgical techniques to provide adequate blood supply to the graft. Hepatic arterial intimal dissection in liver transplantation is although a rare but documented complication, with incidence of less than 5%, but having dreadful complications. To overcome this complication of Recipient hepatic artery dissection, various techniques have been described by different authors. Here, in this case report we are describing technique of utilization of transposed recipient splenic artery for graft arterial inflow where native hepatic artery was dissected up to common hepatic artery. Post-operative recovery was uneventful and on follow up, patient was absolutely fine. So, recipient splenic artery is a safe alternative option in such complex situations for providing arterial blood flow to the graft and moreover it avoids the burden of extra anastomosis which is required in conduit technique.

scholarly journals A new rat model of auxiliary partial heterotopic liver transplantation with liver dual arterial blood supply

2014 ◽  
Vol 9 (2) ◽  
pp. 367-371
Author(s):  
JIANLIANG QIAO ◽  
CHUNLEI HAN ◽  
JUNJING ZHANG ◽  
ZHIYONG WANG ◽  
XINGKAI MENG
Keyword(s):  
Liver Transplantation ◽  
Blood Supply ◽  
Rat Model ◽  
Arterial Blood Supply ◽  
Arterial Blood

scholarly journals Initial experience in direct graft perfusion assessment following orthotopic liver transplant

2020 ◽  
Vol 22 (3) ◽  
pp. 99-106
Author(s):  
A. V. Moiseenko ◽  
A. A. Polikarpov ◽  
P. G. Tarazov ◽  
D. A. Granov
Keyword(s):  
Blood Supply ◽  
Objective Evaluation ◽  
Diagnostic Value ◽  
Good Time ◽  
Arterial Graft ◽  
Perfusion Study ◽  
Arterial Blood Supply ◽  
Splenic Artery Embolization ◽  
Arterial Blood ◽  
Arterial Complications

Objective: classical methods of determining arterial blood supply of the graft following orthotopic liver transplantation (OLT) reflect the presence of blood flow in the trunk and large branches of the A. hepatica, without the characteristic of completeness of blood filling of peripheral sections, which is very important for objective evaluation of function. The aim of this study is to establish the diagnostic value of a direct perfusion study (IFlow) of the graft. Materials and methods. From 1998 to 2019, 245 OLTs were conducted. From 2015 to 2019, arterial changes were detected in 24 (23%) patients after 104 OLTs. A perfusion study was performed in 9 patients with suspected arterial graft failure. According to the IFlow study, liver hypoperfusion due to stenosis and/or splenic steal syndrome was detected in 8 cases and became an indication for therapeutic intervention. Results. Hepatic stenting and/or splenic artery embolization was performed to improve arterial blood supply to the liver. Endovascular procedures performed restored the perfusion index from 0.24 (0.01–0.89) to 0.61 (0.35–0.98). Conclusion. Absence of ultrasound and multispiral computed tomography signs of arterial complications does not rule out the need for perfusion angiography. Perfusion angiography allows to objectify the angiography data and perform corrective intervention in good time.

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