The possibilities of interventional radiology before and after orthotopic liver transplantation

A V Moiseenko,A G Karahanova,D A Granov,A A Polikarpov,P G Tarazov,C V Shapoval,A R Sheraliev

doi:10.15825/1995-1191-2018-3-75-79

A V Moiseenko, A G Karahanova + Show 5 more

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https://doi.org/10.15825/1995-1191-2018-3-75-79

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Abstract

Presented the case of a combined approach preparation of 47 years old patient with primary biliary cirrhosis for orthotopic liver transplantation (OLT) and arterial flow insufficiency correction after surgery. The patient was under waiting list for OLT due liver cirrhosis progression. The patient underwent Intraportal infusion of autologous bone marrow mononuclear cells (MNC) which is allowed temporary stabilized the cirrhotic transformation. The transjugular intrahepatic portosystemic shunt (TIPS) procedure performed due to portal hypertension progression with episodes of bleeding from the esophageal and gastric varices, that allowed to receive organ donor and OLT. At 6 months after OLT the patient had clinical signs of a jaundice caused by splenic artery steal syndrome which was corrected by endovascular intervention: splenic artery trunk embolization.

Highlights

The patient was under waiting list for orthotopic liver transplantation (OLT) due liver cirrhosis progression
At 6 months after OLT the patient had clinical signs of a jaundice caused by splenic artery steal syndrome which was corrected by endovascular intervention: splenic artery trunk embolization
The preparation of liver: а – cirrhotic transformation of the organ; the white arrow – the uncovered part of the transjugular intrahepatic portosystemic shunt (TIPS) corresponds to the proximal part of the right hepatic vein; б – portosystemic shunt on the cut of the preparation; the black arrow is the covered part of the stent; white arrows – distal and proximal uncovered parts of the shunt ки на сегментарном уровне, что потребовало проведения диагностической ангиографии

Summary

Introduction

В листе ожидания ортотопической трансплантации печени (ОТП) находились 635 пациентов. Это создает неблагоприятные условия для артериального кровоснабжения будущего органа и способствует развитию билиарных стриктур после ОТП [6]. После определения при помощи шприца-инжектора оптимальной скорости инфузии (1 мл/с) с уровня бифуркации долевых ветвей воротной вены введено 98 мл суспензии мононуклеарных клеток аутологичного костного мозга

Results

Conclusion