Maximizing Deceased-Donor Allograft Utilization: Management of a Celiac Artery Aneurysm in a Deceased-Donor Liver

被引:2
作者
Slivca, Oleg [1 ]
Olowofela, Ayokunle S. [1 ]
Serrano, Oscar K. [1 ,2 ,3 ]
Pruett, Timothy L. [1 ]
机构
[1] Univ Minnesota, Sch Med, Dept Surg, Div Transplantat, Minneapolis, MN 55455 USA
[2] Hartford Hosp, Transplant Program, Hartford, CT 06115 USA
[3] Univ Connecticut, Sch Med, Farmington, CT USA
关键词
Celiomesenteric aneurysm; Extended criteria donor; Liver transplant; VASCULAR COMPLICATIONS; TRANSPLANTATION;
D O I
10.6002/ect.2019.0023
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
As the scarcity of transplantable organs continues to rise, compounded with an aging donor population, transplant surgeons are increasingly confronted with organ offers from less than ideal donors. The presence of a celiomesenteric aneurysm involving the vascular supply of a donor allograft may predispose to vascular complications in the transplanted liver. We present a 61-year-old brain-dead donor who was discovered to have a celiac artery aneurysm during organ recovery. After gross atherosclerotic or mycotic involvement was ruled out and after careful consideration of the vascular reconstructive options, the donor common hepatic artery was divided distal to the aneurysmal dilatation and anastomosed to the recipient bifurcation of the left and right hepatic artery in an end-to-end beveled anastomosis. The postoperative course was unremarkable, with normal blood flow through the anastomosis and no significant com plications. The recipient is doing well 6 months after transplant. The presence of a celiomesenteric aneurysm should not discourage the use of an otherwise adequate liver graft. Careful vascular reconstruction is encouraged to increase the rate of marginal graft utilization and minimize vascular complications. Liberal postoperative imaging can enable early detection of vascular complication and prompt intervention. Through this case, we demons trate the remarkable potential of less-than-ideal grafts with acceptable posttransplant outcomes.
引用
收藏
页码:1103 / 1105
页数:3
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