Central venous thrombosis and perioperative vascular access in adult intestinal transplantation

British Journal of Anaesthesia
Takashi MatsusakiS Aggarwal

Abstract

Venous access is crucial in intestinal transplantation, but a thrombosed venous system may prevent the use of central veins of the upper body. The incidence of venous thrombosis and the necessity to perform alternative vascular access (AVA) in intestinal transplant recipients have not been fully investigated. Records of adult patients who underwent intestinal transplantation between January 1, 2001, and December 31, 2009, were reviewed. Contrast venography was performed as pre-transplantation screening. Vascular accesses at the transplantation were categorized as I (percutaneous line via the upper body veins), II (percutaneous line via the lower body veins), and III (vascular accesses secured surgically, with interventional radiology, or using non-venous sites). Categories II and III were defined as AVA. Risk factors for central venous thrombosis and those for requiring AVA were analysed, respectively. Among 173 patients, central venous obstruction or stenosis (<50% of normal diameter) was found in 82% (141 patients). AVA was required in 4.6% (eight patients: four in each category II and III). Large-bore infusion lines were placed via the femoral arteries in all category III patients without complications. Existing inferior ven...Continue Reading

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Citations

Mar 5, 2016·Journal of Pediatric Surgery·Jessica Gonzalez-HernandezHannah G Piper
Dec 20, 2015·Transplantation Reviews·Aparna Dalal
Aug 13, 2017·Clinical Transplantation·Jeron ZerilloSamuel DeMaria

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