Orthotopic liver transplantation: Postoperative complications and their management
作者:
R. M. Kirby,
P. McMaster,
D. Clements,
S. G. Hubscher,
L. Angrisani,
M. Sealey,
B. K. Gunson,
P. J. Salt,
J. A. C. Buckels,
D. H. Adams,
W. A. J. Jurewicz,
A. B. Jain,
E. Elias,
期刊:
British Journal of Surgery
(WILEY Available online 1987)
卷期:
Volume 74,
issue 1
页码: 3-11
ISSN:0007-1323
年代: 1987
DOI:10.1002/bjs.1800740103
出版商: John Wiley&Sons, Ltd.
关键词: Liver transplantation;cyclosporin A;postoperative complications
数据来源: WILEY
摘要:
AbstractThe Birmingham liver transplant programme started in 1982. Forty‐six patients have been transplanted with a follow‐up of 3 months or longer. Twenty‐seven patients are still alive, of whom sixteen have lived for more than one year. The 30 day hospital mortality was 30·4 per cent and the actuarial predicted one year survival 55·5 per cent. Four patients have been regrafted for chronic rejection and graft failure. Thirteen patients have required surgery in the postoperative period for: bleeding (two), removal of abdominal packs (four), biliary leaks and obstruction (five), duodenal perforation (one) and small bowel obstruction (one). Acute rejection was common, occurring in 30 patients and progressing to chronic rejection in 4. Ten patients developed renal failure with an 80 per cent mortality and eleven patients developed grand mal fits. Severe bleeding (>70 units) was associated with previous abdominal surgery and a high mortality (88·9 per cent). Opportunistic fungal infection carried a 100 per cent mortality. Although more than half of all transplanted patients will survive for more than one year, the postoperative period is still one of high morbidity and m
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