Gastroduodenal artery steal syndrome during liver transplantation: Intraoperative diagnosis with Doppler ultrasound and management

Seigo Nishida, Jun Kadono, Werviston DeFaria, David M. Levi, Jang I. Moon, Andreas G. Tzakis, Juan R. Madariaga

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Arterial steal syndrome (ASS) after liver transplantation has been reported. ASS causes arterial hypo-perfusion of the graft liver and devastating consequences. However, the diagnosis tends to be delayed. We present the recognized case of a gastroduodenal artery (GDA) steal syndrome that was diagnosed with intraoperative Doppler ultrasound and treated with GDA ligation during the liver transplantation. The patient had variation of hepatic artery anatomy (low bifurcation of the hepatic artery). Graft liver had the common hepatic artery and aberrant left hepatic artery. Doppler ultrasound of the liver was performed after the arterial reconstruction between the donor common hepatic artery and recipient right hepatic artery. It showed low hepatic arterial flow. There is no backflow bleeding from the donor aberrant left hepatic artery stump. After ligating big GDA, hepatic arterial waveform inside the liver drastically improved and strong backflow bleeding was recognized from the donor left aberrant hepatic artery stump. The current case should show the efficacy of intraoperative Doppler ultrasound of the liver on ASS and alert clinician to ligate GDA to prevent ASS if hepatic arterial flows are suboptimal.

Original languageEnglish (US)
Pages (from-to)350-353
Number of pages4
JournalTransplant International
Volume18
Issue number3
DOIs
StatePublished - Mar 2005

Keywords

  • Doppler ultrasound
  • Gastroduodenal artery steal syndrome
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

Fingerprint Dive into the research topics of 'Gastroduodenal artery steal syndrome during liver transplantation: Intraoperative diagnosis with Doppler ultrasound and management'. Together they form a unique fingerprint.

Cite this