Skip to main content
SpringerLink
Log in

Hepatic abscesses after liver transplantation secondary to traumatic intrahepatic bile duct injuries in a cadaveric allograft donor

  • Case Report
  • Published:
Transplant International

Abstract

We report the case of an ultimately successful liver transplant recipient whose post-transplant course was complicated by the early development of multiple abscesses in the graft. Post-transplant cholangiography identified multiple shear injuries to the second and third order intrahepatic bile ducts, originating from blunt trauma to the donor liver. Treatment was non-operative following recent reports of the successful management of intrahepatic bile duct injury in the stable trauma patient. This discussion adds to the limited literature available on the transplantation of injured donor livers, despite this being a relatively common practice. Further experience is needed in determining the appropriate criteria for the use of traumatized donor livers. Cholangiography carried out on the back table may help to determine if such injured livers are suitable for transplantation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3a–c

Similar content being viewed by others

References

  1. Everhart JE, Lombardero M, Detre KM, et al. Increased waiting time for liver transplantation results in higher mortality. Transplantation 1997; 64:1300.

    Article  CAS  PubMed  Google Scholar 

  2. Broering DC, Gundlach M, Bockhorn M, Malago M, Rogiers X. Transplantation of traumatized livers: is it safe? Transplant Proc 1999; 31:540.

    Article  CAS  PubMed  Google Scholar 

  3. Avolio AW, Agnes A, Chirico ASA, Cillo U, Frongillo F, Castagneto M. Successful transplantation of an injured liver. Transplant Proc 2000; 32:131.

    Article  CAS  PubMed  Google Scholar 

  4. De Carlis L, Sansalone CV, Rondinara GF, et al. Is the use of marginal donors justified in liver transplantation? Analysis of results and proposal of modern criteria. Transplant Int 1996; 9: S414.

    Google Scholar 

  5. Goodman DA, Tiruchelvam V, Tabb DR, Agarwal N, Rhoads JE Jr. 3D CT reconstruction in the surgical management of hepatic injuries. Ann Roy Coll Surg Engl 1995; 77:7.

    CAS  Google Scholar 

  6. Webb M, Puig R, Khan F, Nery J, Russell E, Tzakis A. Intraoperative donor cholangiography. Liver Transplant 1998; 4:297.

    CAS  Google Scholar 

  7. Moore E, Cogbill T, Jurkovich G, Shackford S, Malangoni M, Champion H. Organ injury scaling: spleen and liver (1994 Revision). J Trauma 1995; 38:323.

    CAS  PubMed  Google Scholar 

  8. Campbell DA, Magee JC, Rudich SM, Punch JD. Hepatic transplantation. In: Greenfield LJ, ed. Surgery: Scientific Principles and Practices. Lippincott Williams and Wilkins, Philadelphia, 2001:577.

  9. Rull R, Garcia Valdecasas JC, Grande L, et al. Intrahepatic biliary lesions after orthotopic liver transplantation. Transplant Int 2001; 14:129.

    Article  CAS  Google Scholar 

  10. Sanchez-Urdazpal L, Gores GJ, Ward EM, et al. Clinical outcome of ischemic-type biliary complications after liver transplantation. Transplant Proc 1993; 25:1107.

    CAS  PubMed  Google Scholar 

  11. Li S, Stratta RJ, Langnas AN, Wood RP, Marujo W, Shaw BW. Diffuse biliary tract injury after orthotopic liver transplantation. Am J Surg 1992; 164:536.

    CAS  PubMed  Google Scholar 

  12. Cloonan TG, Trerotola SO, Jinal RM. Percutaneous repair of a traumatic bile duct laceration in a liver transplant allograft. J Vasc Interv Radiol 1998; 9:602.

    CAS  PubMed  Google Scholar 

  13. D’Amours SK, Simons RK, Scudamore CH, Nagy AG, Brown DR. Major intrahepatic bile duct injuries detected after laparotomy: selective nonoperative management. J Trauma 2001; 50:480.

    PubMed  Google Scholar 

  14. Filiciano DV, Pacter HL. Current problems in surgery–hepatic trauma revisited. Curr Probl Surg 1989; 26:453.

    PubMed  Google Scholar 

  15. De Backer A, Fierens H, De Schepper A, Pelckmans P, Jorens PG, Vaneerdeweg W. (1998) Diagnosis and nonsurgical management of bile leak complicated by biloma after blunt liver injury: report of two cases. Eur Radiol 1998; 8:1619.

    Article  PubMed  Google Scholar 

  16. Schroeder T, Malago M, Debatin JF, et al. Multidetector computed tomographic cholangiography in the evaluation of potential living liver donors. Transplantation 2002; 73:1972.

    Article  PubMed  Google Scholar 

  17. Simon DM, Levin S. Infectious complications of solid organ transplantation. Infect Dis Clin North Am 2001; 15:521.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Surgery, University of British Columbia, Vancouver, British Columbia, Canada

    S. E. Cowie, S. W. Chung, A. K. Buczkowski & C. H. Scudamore

  2. British Columbia Transplant Society, Vancouver, British Columbia, Canada

    E. M. Yoshida, S. W. Chung, A. K. Buczkowski, S. R. Erb, U. P. Steinbrecher & C. H. Scudamore

  3. Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada

    E. M. Yoshida, S. R. Erb & U. P. Steinbrecher

  4. Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada

    A. G. Ryan & S. G. Ho

  5. Section of Hepatobiliary and Pancreatic Surgery, University of British Columbia, Vancouver, British Columbia, Canada

    S. W. Chung, A. K. Buczkowski & C. H. Scudamore

  6. Second floor, 855 West 10th Avenue, Vancouver, British Columbia, V5Z 1L7, Canada

    C. H. Scudamore

Authors
  1. S. E. Cowie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. M. Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. G. Ryan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. W. Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. K. Buczkowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. G. Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. R. Erb
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. U. P. Steinbrecher
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. H. Scudamore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. H. Scudamore.

About this article

Cite this article

Cowie, S.E., Yoshida, E.M., Ryan, A.G. et al. Hepatic abscesses after liver transplantation secondary to traumatic intrahepatic bile duct injuries in a cadaveric allograft donor. Transpl Int 17, 379–383 (2004). https://doi.org/10.1007/s00147-004-0727-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00147-004-0727-2

Keywords

Search

Navigation