Clinical significance of gastrointestinal bleeding after living donor liver transplantation. (10th May 2014)

• Record Type: Journal Article
• Authors: Kimura, Koichi; Ikegami, Toru; Bekki, Yuki; Ninomiya, Mizuki; Yamashita, Yo‐ichi; Yoshizumi, Tomoharu; Yoshiya, Shohei; Soejima, Yuji; Harada, Noboru; Shirabe, Ken; Maehara, Yoshihiko
• Is Part Of: Transplant international. Volume 27:Number 7(2014:Jul.)
• Page Start: 705
• Page End: 711
• Publication Date: 2014-05-10
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12325
• Languages: English
• ISSNs: 0934-0874

Abstract

<abstract abstract-type="main" id="tri12325-abs-0001"> <title>Summary</title> <p>The clinical presentations of gastrointestinal bleeding (GIB) occurring after living donor liver transplantation (LDLT) have not been fully described. We performed a retrospective analysis of 297 LDLT cases. Nineteen patients (6.4%) experienced GIB after LDLT. The etiology of GIB included bleeding at the jejunojejunostomy following hepaticojejunostomy (<italic>n </italic>=<italic> </italic>13), peptic ulcer disease (<italic>n </italic>=<italic> </italic>2), portal hypertensive gastropathy (<italic>n </italic>=<italic> </italic>2), and other causes (<italic>n </italic>=<italic> </italic>2). Hemostasis was achieved in 13 patients (68.4%) by endoscopic (<italic>n </italic>=<italic> </italic>3), surgical (<italic>n </italic>=<italic> </italic>1), or supportive treatments (<italic>n </italic>=<italic> </italic>15), but not in the other six patients. Graft dysfunction (<italic>P </italic><<italic> </italic>0.001), hepaticojejunostomy (<italic>P </italic>=<italic> </italic>0.01), portal vein pressure at the end of surgery >20 mmHg (<italic>P </italic>=<italic> </italic>0.002), and operative blood loss >10 L (<italic>P </italic>=<italic> </italic>0.004) were risk factors. One‐year graft survival rate was significantly lower in patients with GIB than in patients without GIB (<italic>P </italic><<italic> </italic>0.001). The inhospital mortality rate was 52.6% for patients with GIB, 75.0% for patients with graft dysfunction, and 14.3% for patients without graft dysfunction (<italic>P </italic>=<italic> </italic>0.028). Despite its infrequency after LDLT, GIB has strong correlation with graft dysfunction and inhospital mortality.</p> </abstract>