Etiology and management of intra-abdominal hemorrhage after orthotopic liver transplantation

/Ma Yi

(馬毅，Dept Transplant Surg，1st Affil Hosp，Sun Yat-sen Univ，Guangzhou 510080)…∥Chin JGen Surg.-2011，26(8).-625 ～628

ObjectiveTo explore the causes and management of intra-abdominal hemorrhage after orthotopic liver transplanktation(OLT).MethodsClinical data of 638 OLT patients were analyzed retrospectively from January 2004 to December 2008 in the First Affiliated Hospital of Sun Yat-sen University.The diagnosis and treatment of postoperative intra-abdominal hemorrhage after OLT were reviewed.ResultsAmong the 638 patients，53 suffered from posttransplant intra-abdominal hemorrhage，the morbidity was 8.3%(53/638).Thirty-one cases suffering from bleeding on raw surfaces or around the liver due to impairment of coagulation function were treated by non-surgery methods，22 cases who suffered from active postoperative intra-abdominal hemorrhage due to surgical factors underwent laparotomy and bleeding control operation after failure of anti-shock treatments such as hemostatic drugs，blood reperfusion.Among the 53 patients who suffered from intra-abdominal hemorrhage，12 patients died，and the main causes were serious infections and multiple organ dysfunction syndrome.The mortality associated with intraabdominal hemorrhage was 22.6%.ConclusionIntra-abdominal hemorrhage at different locations were found after OLT，and the fatal rate is quite high.Timely and appropriate treatments especially laparotomy may improve the prognosis of these patients.9 refs，1 tab