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Orthotopic Liver Transplantation: Complications

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Contemporary Liver Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

Abstract

Orthotopic liver transplantation (OLT) can be complicated by medical or surgical complications. Medical complications include delayed graft function or primary nonfunction (PNF), rejection, neurologic complications (encephalopathy, tremors, central pontine myelinolysis, and seizures), pulmonary complications (pleural effusions, hospital-acquired pneumonia, pulmonary edema, adult respiratory distress syndrome), and cardiovascular complications (hypertension, hyperlipidemia, diabetes, and obesity). Surgical complications may include hemorrhage, vascular complications (hepatic artery thrombosis or stenosis, pseudoaneurysm, portal vein stenosis or thrombosis, hepatic vein or vena cava stenosis), and biliary complications (anastomotic stricture and biliary leak). Hepatic artery thrombosis is the leading cause of graft loss and mortality after OLT. Re-transplantation is the treatment of choice for most cases of hepatic artery, and portal vein thrombosis, and percutaneous balloon angioplasty for hepatic artery, portal vein, and hepatic vein stenosis. Biliary complications such as biliary leak or stricture can be managed successfully by endoscopic or percutaneous biliary drainage, while surgical biliary reconstruction is the treatment of choice for biliary drainage nonresponders. Medical and surgical complications remain significant causes of morbidity and mortality post-OLT requiring early recognition, diagnosis, and immediate treatment.

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Authors and Affiliations

  1. Transplant Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Carlo Gerardo B. Ramirez

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  1. Carlo Gerardo B. Ramirez
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Correspondence to Carlo Gerardo B. Ramirez .

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Editors and Affiliations

  1. Nicoletti Family Professor of Transplant Surgery, Director, Jefferson Transplant Institute, Director, Division of Transplantation, Surgical Director, Kimmel Cancer Center – Jefferson Liver Tumor Center, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA

    Cataldo Doria

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© 2017 Springer International Publishing Switzerland

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Ramirez, C.G.B. (2017). Orthotopic Liver Transplantation: Complications. In: Doria, C. (eds) Contemporary Liver Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07209-8_41

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  • DOI: https://doi.org/10.1007/978-3-319-07209-8_41

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-07208-1

  • Online ISBN: 978-3-319-07209-8

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