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Complex liver retransplantation to treat graft loss due to long-term biliary tract complication after liver transplantation: A case report

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World Journal of Clinical Cases 2020年第3期8卷 568-576页

作者： Jiang Li Qing-Jun Guo Wen-Tao Jiang Hong Zheng Zhong-Yang Shen Department of liver Transplant Tianjin First Central Hospital

BACKGROUND Loss of graft function after liver transplantation(LT) inevitably requires liver retransplant. Retransplantation of the liver(Re LT) remains controversial because of inferior outcomes compared with the primary orthotopic LT(OLT).Meanwhile, if accompanied by vascular complications such as arterial and portal vein(PV) stenosis or thrombosis, it will increase difficulties of surgery. We hereby introduce our center’s experience in Re LT through a complicated case of *** SUMMARY We report a patient who suffered from hepatitis B-associated cirrhosis and underwent LT in December 2012. Early postoperative recovery was *** months after LT, the patient’s bilirubin increased significantly and he was diagnosed with an ischemic-type biliary lesion caused by hepatic artery occlusion. The patient underwent percutaneous transhepatic cholangial drainage and repeatedly replaced intrahepatic biliary drainage tube regularly for 5 *** patient developed progressive deterioration of liver function and underwent liver re-transplant in January 2019. The operation was performed in a classic OLT manner without venous bypass. Both the hepatic artery and PV were occluded and could not be used for anastomosis. The donor PV was anastomosed with the recipient’s left renal vein. The donor hepatic artery was connected to the recipient’s abdominal aorta. The bile duct reconstruction was performed in an end-to-end manner. The postoperative process was very uneventful and the patient was discharged 1 mo after *** With the development of surgical techniques, portal thrombosis and arterial occlusion are no longer contraindications for ReLT.

关键词： liver retransplantation Biliary tract complication Ischemic type biliary lesion Portal vein thrombosis Arterial occlusion graft liver failure Case report

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