J Korean Soc Transplant.  2007 Dec;21(2):188-195.

Patterns and Treatment of the Surgical Complications following Living Donor Liver Transplantation

• Hwang S
• Lee SG
• Ahn CS
• Kim KH
• Moon DB
• Ha TY
• Song GW
• Jung DH

Abstract

Living donor liver transplantation has definite demerits vulnerable to various surgical complications because the anatomy of the donor liver should be securely shared to ensure both donor safety and graft liver reconstruction. Major surgical complications can be classified into 3 types as intraabdominal bleeding, vascular anastomotic stenosis, and biliary complication. The sources of intraabdominal bleeding include the right inferior phrenic artery, right adrenal, graft liver cut surface, intrahepatic pseudoaneurysm, splenic artery aneurysm, hepatic artery anastomosis leak, and bowel anastomosis site. Radiologic intervention has been attempted for diagnostic and therapeutic intentions. There are several obligatory indications requiring emergency laparotomy for bleeding control. Significant stenosis can occur at every vascular anastomosis site of the liver graft. Metallic wall stents can be used to treat the anastomotic stenosis at the portal vein, hepatic vein and even hepatic artery. Biliary complication is the most common complication. Bile leak from the anastomotic site is often associated with serious infectious complication and subsequent stenosis. Biliary stenosis is usually not fatal, but often makes the quality of life deteriorate for a long time because it requires repeated treatment procedures. Bile leak at the graft liver cut surface is not common unless there is a technical fault during donor hepatectomy. The principle to cope with these surgical complications is to treat them in time and aggressively after consideration of the underlying causes and available treatment modalities.

Keyword

Living donor liver transpla; Complication; Bleeding; Stenosis; Leak

MeSH Terms

Aneurysm
Aneurysm, False
Arteries
Bile
Constriction, Pathologic
Emergencies
Hemorrhage
Hepatectomy
Hepatic Artery
Hepatic Veins
Humans
Intention
Laparotomy
Liver Transplantation*
Liver*
Living Donors*
Portal Vein
Quality of Life
Splenic Artery
Stents
Tissue Donors
Transplants