Artikel
Outcome after orthotopic liver transplantation using aortic conduits vs. standard arterial anastomosis
Suche in Medline nach
Autoren
-
Christian Denecke
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Rorarius Jannis
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Claudia Boesmueller
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Matthias Biebl
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Felix Aigner
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Stefan Schneeberger
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Johann Pratschke
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
-
Robert Oellinger
- Medizinische Universitaet Innsbruck, Viszeral-, Transplantations - und Thoraxchirurgie, Innsbruck
| Veröffentlicht: | 21. März 2014 |
|---|
Gliederung
Text
Introduction: Anastomosis of donor and recipient hepatic artery is the standard technique in orthotopic liver transplantation. In case of insufficient access to the recipient hepatic artery, revascularization using a donor iliac arterial interposition graft to the recipient aorta can be necessary. We analyzed the outcome of patients with aortic conduits in our center.
Material and methods: Patients undergoing liver transplantation at the Department of Surgery, Innsbruck, between 1977 and 2012 were included in the study. Donor, recipient and procedure related factors were retrospectively analysed focusing on the type of arterial reconstruction. Endpoint was 1- and 5-year graft and patient survival after transplantation.
Results: In the observational period 1148 liver transplants were carried out, 18 patients were lost to follow up. Median 1- and 5 year patient survival with standard hepatic artery anastomosis and conduit grafts was 90.5 % vs 74.2 and 83.3% vs 68.5% (p< 0.0005), respectively. In 53 (4.6 %) patients a conduit to the recipient aorta or iliac artery was conducted according to the surgeons preference. Among them, 15 (28.3%) were re-transplants as compared to 38 (3.5%) retransplantations among patients with a standard arterial anastomosis.
Conclusion: Long term survival is inferior in patients with aortic conduits. However, survival beyond 1 year was comparable between the groups. Of note, the retransplantation rate was higher in the aortic conduit group.
