Transpl Int. 2011 Mar;24(3):e19-22. doi: 10.1111/j.1432-2277.2010.01186.x. Epub 2010 Nov 11.

Hepatic arterial embolization for massive bleeding from an intrahepatic artery pseudoaneurysm using N-butyl-2-cyanoacrylate after living donor liver transplantation.

Ou HY, Concejero AM, Yu CY, Huang TL, Chen TY, Tsang LL, Chen CL, Wang SH, Cheng YF.

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Liver Transplant Program and Department of Diagnostic Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Niao-Sung, Kaohsiung, Taiwan.

Abstract

Parenchymal pseudoaneurysm of the hepatic arteries with massive intraperitoneal bleeding is rare but a serious life-threatening complication when it occurs following liver transplantation. We report a case of an adult postliving donor liver transplant recipient who developed massive subcapsular bleeding combined with massive right pleural effusion from ruptured multiple small intrahepatic arteries, which developed from a pseudoaneurysm that was treated by hepatic arterial embolization. Successful embolization was performed via a percutaneous trans-catheter approach by depositing 20-25%N-butyl-2-cyanoacrylate (NBCA) through the multiple small intrahepatic arteries into the pseudoaneurysm. Complete occlusion of the feeding arteries and pseudoaneurysm cavity resulted to immediate cessation of bleeding. There was no re-bleeding; and normal liver graft function was noted postembolization. Hepatic arterial embolization with NBCA can be used as treatment for postliver transplant peripheral intrahepatic artery pseudoaneurysm bleeding.

PMID:: 21070387; [PubMed - indexed for MEDLINE]

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