Massive hepatic artery atherosclerosis of an otherwise suitable donor liver: a case report
Most of the few reports about hepatic artery disease found in the literature describe hepatic artery aneurysms or hepatic artery calcifications. Atherosclerosis of the hepatic artery is not commonly evaluated during deceased donor liver procurement. Herein we present a case of a stable 47-year-old C...
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Published in | Transplantation proceedings Vol. 36; no. 5; pp. 1438 - 1441 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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New York, NY
Elsevier Inc
01.06.2004
Elsevier Science |
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Abstract | Most of the few reports about hepatic artery disease found in the literature describe hepatic artery aneurysms or hepatic artery calcifications. Atherosclerosis of the hepatic artery is not commonly evaluated during deceased donor liver procurement. Herein we present a case of a stable 47-year-old Caucasian female donor whose liver function tests were within normal limits and a liver biopsy showed less than 5% steatosis. The liver when received at our center appeared grossly unremarkable. Back-table evaluation showed a complete occlusion of the trunk of the proper hepatic artery. The pathology report revealed hepatic occlusion due to arterial atherosclerosis. Transplantation was canceled, and the liver was used for isolated hepatocyte perfusion, revealing <25% hepatocyte viability. Hepatic artery atherosclerosis and patency need to be evaluated at the time of procurement to prevent recipient morbidity due to anesthetic induction, or initiation of a recipient abdominal incision prior to declining the liver graft for this rare finding. |
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AbstractList | Most of the few reports about hepatic artery disease found in the literature describe hepatic artery aneurysms or hepatic artery calcifications. Atherosclerosis of the hepatic artery is not commonly evaluated during deceased donor liver procurement. Herein we present a case of a stable 47-year-old Caucasian female donor whose liver function tests were within normal limits and a liver biopsy showed less than 5% steatosis. The liver when received at our center appeared grossly unremarkable. Back-table evaluation showed a complete occlusion of the trunk of the proper hepatic artery. The pathology report revealed hepatic occlusion due to arterial atherosclerosis. Transplantation was canceled, and the liver was used for isolated hepatocyte perfusion, revealing <25% hepatocyte viability. Hepatic artery atherosclerosis and patency need to be evaluated at the time of procurement to prevent recipient morbidity due to anesthetic induction, or initiation of a recipient abdominal incision prior to declining the liver graft for this rare finding. Most of the few reports about hepatic artery disease found in the literature describe hepatic artery aneurysms or hepatic artery calcifications. Atherosclerosis of the hepatic artery is not commonly evaluated during deceased donor liver procurement. Herein we present a case of a stable 47-year-old Caucasian female donor whose liver function tests were within normal limits and a liver biopsy showed less than 5% steatosis. The liver when received at our center appeared grossly unremarkable. Back-table evaluation showed a complete occlusion of the trunk of the proper hepatic artery. The pathology report revealed hepatic occlusion due to arterial atherosclerosis. Transplantation was canceled, and the liver was used for isolated hepatocyte perfusion, revealing < 25% hepatocyte viability. Hepatic artery atherosclerosis and patency need to be evaluated at the time of procurement to prevent recipient morbidity due to anesthetic induction, or initiation of a recipient abdominal incision prior to declining the liver graft for this rare finding. |
Author | Clark, B.D Posner, M.P Maluf, D Cotterell, A.H Fisher, R.A |
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References | Harward, Smith, Seeger (BIB2) 1993; 17 White, Wilson (BIB5) 1994; 13 Saiura, Umekita, Inoue (BIB7) 2001; 48 Pai, Bude (BIB3) 2002; 30 Christensen, Lorentzen, Schroeder (BIB4) 1995; 9 Accessed November 27, 2003 Available at Desai, Paushter, Armistead (BIB6) 1989; 8 Colombo, Tinozzi, Abelli (BIB1) 2002; 73 (BIB8) 1999 Desai (10.1016/j.transproceed.2004.05.007_BIB6) 1989; 8 Colombo (10.1016/j.transproceed.2004.05.007_BIB1) 2002; 73 10.1016/j.transproceed.2004.05.007_BIB9 (10.1016/j.transproceed.2004.05.007_BIB8) 1999 Christensen (10.1016/j.transproceed.2004.05.007_BIB4) 1995; 9 Saiura (10.1016/j.transproceed.2004.05.007_BIB7) 2001; 48 Harward (10.1016/j.transproceed.2004.05.007_BIB2) 1993; 17 Pai (10.1016/j.transproceed.2004.05.007_BIB3) 2002; 30 White (10.1016/j.transproceed.2004.05.007_BIB5) 1994; 13 |
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SubjectTerms | Aorta, Abdominal - pathology Arteriosclerosis - pathology Arteriosclerosis - surgery Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Brain Death Cardiology. Vascular system Female Hepatectomy - methods Hepatic Artery - pathology Hepatic Artery - surgery Humans Liver Transplantation - methods Liver, biliary tract, pancreas, portal circulation, spleen Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Tissue and Organ Harvesting - methods |
Title | Massive hepatic artery atherosclerosis of an otherwise suitable donor liver: a case report |
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