1. FAP I treated by liver transplant (18 cases): surgical morbidity and mortality
- Author
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Ramirez, P, Robles, R, Lujan, J, Pons, JA, Miras, M, L., Andreu F, Munar-Ques, M, Acosta, F, Mingo, P De, Rodrigues, JM, S., Garrido FJ, and Parrilla, P
- Abstract
The aims of this paper were: 1) To analyse the morbidity and mortality rates in relation to surgical technique in 18 patients with FAP I treated by liver transplant (LT) and, 2) To study the indication for veno-venous by-pass during the anhepatic phase. Patients and Methods During a 4-year period (September 1991-June 1995) 18 patients diagnosed with FAP I underwent a liver transplant (LT). The mean cold ischaemic time was 323+ −44 min, the mean surgical time in the recipient was 279+ −68 min and the mean red blood transfusion was 13.1+ −6 units. Veno-venous by-pass was indicated when the systolic blood pressure was under 100 mm Hg or the cardiac index decreased more than 50% after portal vein and inferior vena cava clamping for 5 minutes. Results 1. In 4 cases our of 12 (33%) we used veno-venous by-pass. In 6 cases we performed the Piggy-Back technique as a first choice procedure. 2. We had no vascular complications or intraoperative complications or intraoperative mortality. Four patients presented biliary tract complications, and reoperation was necessary in 3 cases. 3. After a mean follow-up of 16.5+ −8 months the mortality rate was 28% (5 cases). Only 1 patient died during the first postoperative month (multiorgan failure). Conclusions 1. LT is an efficient treatment in FAP I, with no intraoperataive mortality, little postoperative mortality (1 month, 1 case) and low morbidity in relation to the surgical technique. 2. FAP I patients present a high rate of non-haemodinamic tolerance during the anhepatic phase and consequently, the Piggy-Back technique could be a first choice procedure in FAP I as an alternative to veno-venous by-pass.
- Published
- 1996
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