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Liver transplantation as definitive therapy for complications after arterial embolization for hepatic manifestations of hereditary hemorrhagic telangiectasia
Author(s) -
Odorico, Jon S.,
Hakim M. Nawar,
Becker Yolanda T.,
Van der Werf Willem,
Musat Alexandru,
Knechtle Stuart J.,
D'Alessandro Anthony M.,
Kalayoglu Munci
Publication year - 1998
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500040609
Subject(s) - medicine , liver transplantation , embolization , sepsis , hepatic artery embolization , biliary sludge , transplantation , surgery , artery , arterial embolization , radiology , gastroenterology , gallbladder
Experience with hepatic artery embolization for the treatment of symptomatic hepatic arteriovenous malformations (AVMs) in Rendu‐Osler‐Weber disease is limited. We report 2 cases of hepatic AVMs that caused mesenteric angina‐like symptoms that were treated with embolization. Both patients developed parenchymal and bile duct necrosis, intrahepatic bilomas, and refractory biliary sepsis, subsequently leading to liver failure. We hypothesize that the pathophysiological cause of biliary necrosis in this setting is similar to that which occurs in the setting of hepatic artery thrombosis of the liver allograft. Progressive liver failure in these patients was treated successfully by liver transplantation. Liver transplantation offers definitive therapy by removing the source of ongoing sepsis, restoring normal liver function, and eliminating the intrahepatic AV shunt.