Mazzaferro, V and Todo, S and Tzakis, AG and Stieber, AC and Makowka, L and Starzl, TE
(1990)
Liver transplantation in patients with previous portasystemic shunt.
The American Journal of Surgery, 160 (1).
111 - 116.
ISSN 0002-9610
Abstract
Over a 9-year period, 58 patients who had previous portasystemic shunt procedures underwent orthotopic liver transplantation (OLTx) under a cyclosporine-steroid immunosuppressive regimen. The types of shunt used were distal splenorenal (18 patients), mesocaval (17 patients), end-to-side portacaval (11 patients), side-to-side portacaval (5 patients) and proximal splenorenal (7 patients). The mean interval between shunt and transplantation was 6 years. There was no statistical difference in survival between patients with previous shunts and the entire population of patients with primary liver transplantation performed during the same period of time. Age, sex, shunt patency, status of portal vein, and use of vein or artery graft did not affect survival. Child's classification had a significant influence on graft survival, even though no difference was subsequently observed in patient survival. A progressively improved intraoperative strategy and the use of veno-venous bypass and University of Wisconsin preservation solution had a significant impact on blood loss, length of operation, length of stay in intensive care unit, and ultimately, on survival. Distal splenorenal and mesocaval shunts with no or minimal hilum dissection are safer shunts if subsequent transplantation is planned; in fact, their 9-year survival was 87%, whereas all other shunts were associated with a survival no better than 52% (p<0.006). © 1990 Reed Publishing USA.
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Item Type: |
Article
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Status: |
Published |
Creators/Authors: |
Creators | Email | Pitt Username | ORCID |
---|
Mazzaferro, V | | | | Todo, S | | | | Tzakis, AG | | | | Stieber, AC | | | | Makowka, L | | | | Starzl, TE | tes11@pitt.edu | TES11 | |
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Centers: |
Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute |
Date: |
1 January 1990 |
Date Type: |
Publication |
Journal or Publication Title: |
The American Journal of Surgery |
Volume: |
160 |
Number: |
1 |
Page Range: |
111 - 116 |
DOI or Unique Handle: |
10.1016/s0002-9610(05)80879-7 |
Institution: |
University of Pittsburgh |
Refereed: |
Yes |
ISSN: |
0002-9610 |
Other ID: |
uls-drl:31735062116458, Starzl CV No. 1091 |
Date Deposited: |
08 Apr 2010 17:18 |
Last Modified: |
02 Feb 2019 13:57 |
URI: |
http://d-scholarship.pitt.edu/id/eprint/4477 |
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