Multidrug-Resistant Bacterial Sepsis and Inferior Vena Cava Thrombosis in Liver Transplant Recipients Used Synthetic Vascular Graft: Three Fatal Cases

Kose A., Ince V., Ozdemir F., Kutlu R., Bayindir Y., Yilmaz S.

INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE, cilt.11, sa.4, ss.196-201, 2020 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 11 Sayı: 4
  • Basım Tarihi: 2020
  • Dergi Adı: INTERNATIONAL JOURNAL OF ORGAN TRANSPLANTATION MEDICINE
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.196-201
  • İnönü Üniversitesi Adresli: Evet

Özet

Synthetic vascular grafts are commonly used in liver transplantation. Thrombosis is a possible complication of using expanded polytetrafluoroethylene (e-PTFE) grafts. Herein, we report on 3 cases of liver recipients who died of intermittent sepsis episodes emerged concurrently with the thrombosis in synthetic vascular grafts and inferior vena cava (IVC) vein. Right lobe liver transplantation from living donors was performed for 3 patients by using e-PTFE grafts between the liver and IVC. Although heparin had been administered, thrombosis was developed in vascular graft and IVC extending to the right atrium; it was developed within 1-4 months of transplantations. All 3 patients suffered from recurrent sepsis episodes (4, 5, and 6 attacks for each patient) by different multidrug-resistant bacterial species. Treatment attempts including thrombolytic and antimicrobial drugs made, and surgical, endoscopic and radiological interventions could not resolve the clinical situation. The patients died of septic complications. We concluded that severe recurrent sepsis attacks may develop in liver transplant recipients when IVC and synthetic vascular graft were thrombosed. Removing the e-PTFE graft may be benefit for the treatment.