INTRODUÇÃO A trombose de veia porta (TVP) em candidatos ao transplante hepático, até passado recente, era considerada contraindicação absoluta para o transplante em razão das dificuldades técnicas e da alta mortalidade34. Foi apenas em 1985 que Shaw et al. relataram o primeiro caso bem sucedido27. Atualmente, com o desenvolvimento de estratégias para vascularização portal do enxerto e refinamento da técnica operatória, o transplante de fígado em pacientes portadores de
INTRODUCTION Graft-versus-host disease (GVHD) following liver transplantation (LT) is an uncommon complication but has high mortality and represents a major diagnostic challenge. GVHD occurs when immunocompetent donor lymphocytes originating from the transplanted liver undergo activation and clonal expansion, allowing them to mount a destructive cellular immune response against recipient tissues. Humoral GVHD is usually seen after an ABO-mismatched liver transplant, but cellular GVHD is directed against the major histocompatibility complex and often results
INTRODUCTION Primary sclerosing cholangitis (PSC) is a chronic cholestatic syndrome with autoimmune features and is associated with other immunological diseases such as autoimmune pancreatitis and inflammatory bowel disease. In addition to primary biliary cirrhosis, PSC is one of the most common chronic cholestatic liver diseases.1 The diagnosis of PSC is a challenge because patients are asymptomatic or display unspecific symptoms. Patients experience fatigue, pruritus, and jaundice. In addition,
Background Abdominal hernias are a common disease among cirrhotic patients, because of malnutrition and persistently high intra-abdominal pressure due to ascites. When tense ascites is present, life-threatening complications are likely to occur. In such cases, the morbidity and mortality rates are high. Objective We describe 3 cirrhotic patients with rare complicated hernias that needed surgical repair. We discuss optimal timing for surgical approaches and the necessity of ascites control before surgery, as well as the technical details of the procedures. Method Review of hospital charts
INTRODUCTION In the last thirty years, hepatic steatosis has been well-documented as the most common chronic liver disease in the general population. Its high prevalence is of epidemiological concern because it affects 31% of adults as evaluated by magnetic resonance imaging in the USA1 and 33% of living donor candidates who underwent liver biopsy.2 The prevalence is directly related to age and varies from 2.6% in children to 26% in adults who are
INTRODUCTION Liver transplantation (LT) techniques have changed continually over the last 4 decades. Caval preservation, first reported by Calne and Williams in 19681 and popularized by Tzakis et al. in 19892 as the piggyback (PB) technique, has been adopted by many transplant teams.3–6 In 1992, we described a procedure preserving the caval flow during
INTRODUCTION In acute pancreatitis (AP), severity and prognosis are directly related with the intensity of the initial damage.1 In 15% of cases, the pancreatic lesion is severe and the mortality varies from 10 to 100%, being greater in those cases where the pancreas is necrotic and infected. Such patients require intensive care for a longer period as well as multiple surgical interventions.2-6 The systemic inflammatory response and the medical care of these patients
INTRODUCTION Unlike arterial aneurysms, primary venous aneurysms are uncommon. Venous aneurysms have been found and described in the popliteal, jugular, and saphenous veins, but occur only rarely in other veins. Portal vein aneurysms represent less than 3% of all venous aneurysms.1 This finding has been increasingly described in recent years probably because radiologic imaging exams are more available in clinical practice. Two forms, congenital and acquired, have been described. Acquired aneurysms are
Abstract The shortage of donor organs and the long waiting lists have increased the need to better select liver transplant candidates using predictors of success. We reviewed the results of 29 liver transplantations performed from January 2002 to February 2003 analyzing the correlations with early mortality (30 days) of patient data, pretransplant laboratory data, warm ischemia time, intraoperations blood unit transfusions, and postoperative complications of prolonged mechanical ventilation, dialysis, and infection. Overall early mortality was 27.6% and 44% in fulminant hepatic
Biliary complications have been reported in 9% to 34% of liver transplant patients. Although most centers seem to prefer a duct-to-duct anastomosis without a T-tube when feasible, the best method of biliary reconstruction remains controversial. The aim of this study was to review our experience on reconstruction of the biliary tract without drainage. Forty-one patients underwent 45 liver transplants over two periods. Forty patients underwent 15 liver transplants from October 1992 to March 1995; and 27 underwent 30 liver transplants
