contemporaneous portal-arterial reperfusion during liver transplantation preliminary results同生portal-arterial再灌注期间肝移植的初步结果.pdfVIP

Hindawi Publishing Corporation Journal of Transplantation Volume 2011, Article ID 251656, 4 pages doi:10.1155/2011/251656 Clinical Study Contemporaneous Portal-Arterial Reperfusion during Liver Transplantation: Preliminary Results G. L. Adani, A. Rossetto, V. Bresadola, D. Lorenzin, U. Baccarani, and D. De Anna Department of Surgery and Transplantation, University Hospital of Udine, 33100 Udine, Italy Correspondence should be addressed to A. Rossetto, rossettoannaar@libero.it Received 26 October 2010; Revised 18 January 2011; Accepted 7 February 2011 Academic Editor: Yuri Genyk Copyright © 2011 G. L. Adani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We prospectively compared sequential portal-arterial revascularization (SPAr, group 1 no. 19) versus contemporaneous portal- hepatic artery revascularization (CPAr, group 2 no. 21) in 40 consecutive liver transplantation (LT). There were no differences in the demographics characteristics, MELD score, indication to LT, and donor’s parameters between the two groups. CPAr had longer warm ischemia 66 ± 8 versus 37 ± 7 min (P .001), while SPAr had longer arterial ischemia 103 ± 42 min (P = .0004). One-year patient’s and graft survival were, respectively, 89% and 95% versus 94% and 100% (P = .29). At median followup of 13 ± 6 versus 14 ± 7 months biliary complications were anastomotic stenosis in 15% versus 19% (P = .78), and intrahepatic nonanastomotic biliary strictures in 26% versus none (P = .01), respectively, in SPAr and CPAr. CPAr reduces the incidence of intrahepatic biliary strictures by decreasing the duration of arterial ischemia. 1. Introduction