Vascular complications following liver transplantation:Aliterature review of advances in 2015

Although vascular complications(VCs) following orthotopic liver transplantation(OLT) seldom occur, they are the most feared complications with a high incidence of both graft loss and mortality, as they compromise the blood flow of the transplant(either inflow or outflow). Diagnosis and therapeutic management of VCs constitute a major challenge in terms of increasing the success rate of liver transplantation. While surgical treatment used to be considered the first choice for management, advances in endovascular intervention have increased to make this a viable therapeutic option. Considering VC as a rare but a major and dreadful issue in OLT history, and in view of the continuing and rapid progress in recent years, an update on these uncommon conditions seemed necessary. In this sense, this review comprehensively discusses the important features(epidemiological, clinical, paraclinical, prognostic and therapeutic) of VCs following OLT.

原位肝移植后血管并发症的血管腔内介入治疗

目的分析总结血管腔内介入治疗在原位肝移植后血管并发症中的作用和意义。资料与方法回顾性分析31例原位肝移植术后血管并发症患者的血管腔内介入治疗资料与随访结果。结果31例患者中单纯肝动脉并发症11例,门静脉并发症11例,腔静脉并发症6例,合并肝动脉与门静脉并发症1例,合并腔静脉、肝静脉、门静脉复杂并发症1例,脾动脉窃血综合征1例。均成功进行了血管腔内介入治疗。共置入肝动脉支架13枚,静脉支架21枚,进行肝动脉栓塞1例,部分性脾动脉栓塞2例,单纯腔静脉球囊扩张1例,1例患者肝动脉局部灌注溶栓后置入肝动脉支架,1例患者先后置入腔静脉、肝静脉与门静脉支架各1枚,1例患者同时置入门静脉和肠系膜上静脉支架。所有血管腔内介入操作成功有效,技术成功率100%,手术相关并发症发生率12.9%,并且并发症经处理无后继影响。随访中除1例肝动脉于支架置入后19天发生再狭窄外,其余血管至随访结束未出现明确再狭窄。结论肝移植术后血管并发症的血管腔内介入治疗安全有效,技术成功率高而并发症发生率低,是一种理想的微创治疗选择。

成人肝移植术后血管、胆道并发症的介入治疗

目的评价介入治疗成人肝移植术后血管、胆道并发症的有效性和安全性。方法 2007年12月至2011年12月,肝移植后出现血管、胆道并发症的患者12例行介入治疗。观察临床症状、并发症及患者存活情况。结果患者术后临床症状缓解,无手术相关严重并发症。中位随访期12个月(4～48个月)内,除1例患者死亡外,余所有患者存活。结论介入治疗肝移植术后血管、胆道并发症是有效和安全的。

肝移植术后血管并发症介入治疗的进展

肝移植术后血管并发症严重威胁患者的生存.在肝移植患者术前血管情况评估及术后病情监测方面,虽然数字减影血管造影（DSA）作为多种血管病变确诊的金标准,但因其创伤性并未作为首选.只有在彩色多普勒超声、螺旋CT、核磁共振等术前常规检查手段难以了解血管解剖关系时DSA才作为确诊手段,并且多数情况下用于治疗血管性病变.本文就目前介入治疗在肝移植术后血管并发症中的应用作一综述,以明确介入技术在肝移植术后相关并发症诊治中的作用.