LIVER-TRANSPLANTATION IN A PATIENT WITH CHOLANGIOCARCINOMA AND ULCERATIVE-COLITIS

  • 1 January 1976
    • journal article
    • research article
    • Vol. 115  (7) , 615-619
Abstract
A 39 yr old patient with cholangiocarcinoma and preexisting ulcerative colitis was successfully treated by orthotopic liver transplantation. He was given low doses of prednisone and azathioprine and survived for more than 9 mo., dying with tumor metastases, thrombosis of the inferior vena cava and an intraabdominal abscess. At autopsy the homograft showed little evidence of rejection. Preoperatively the patient had septicemia. Removal of his liver was difficult. The discrepancy between donor and recipient in size of blood vessels and the presence of 2 hepatic arteries in the donor caused problems during the vascular anastomoses. During the operation cardiac arrest occurred. Postoperatively there were several medical and surgical problems, including intraperitoneal and gastrointestinal hemorrhage, paralysis of the right dome of the diaphragm, sinus bradycardia, massive diuresis, peroneal nerve palsy and 1 major and 3 minor episodes of rejection, which were reversed by giving pulse doses of methylprednisolone i.v.