7. Listing for LT in «Super Urgence»
•First proposal was refused (at H1 after listing)
–Male, 86 year-old with GGT 800 UI/ml
•Second proposal (at H12… after listing)
–Male, 45 yea-old, 82 kg for 1.80 m, Gr 0-
–48 hours of ICU for Cerebral Stroke and Anoxia
Bili
ASAT
ALAT
GGT
At Admiss.
30μmol/L
1280
450
1330
AtProposal
6μmol/L
316
151
492
8. The graft… from France South West..
Evaluation by the surgeon who make the retrieval : Big graft, probably steaotic but transplantable… Frozen section not feasible in situ, we need to come back to Paris We increased Cold Ischemia of 8 hours…..
We accepted these graft because the recipient is more and more severe….
9. Liver Transplantation under veno-venous
bypass with VC replacement
VC Replacement and CEC : Big graft (Risk of VC compression) + Acute Pancreatitis
Cold Ischemia : 10h00
25 Red Pack Cell…
Diffuse hemorrhage…
Levesque et al, Vibert. Clin Tranpl 2012
10. At the end of liver transplantation
Volume of the graft, Acute pancreatis, Hemorrhage… and probable re LT
11. Evolution at Day 1 from LT
Biopsyofthegraft:Morethan50%ofmacrosteatosisand10%ofmicrosteatosis…
/ LT
Bili
ASAT
ALAT
PT/ Fact V
AtH4
117
6607
1482
34/ 23
AtH12
130
5900
1200
23/ 15
Under Noradrenaline, no bleeding
12. Re Listing for LT in «Super Urgence»
•First proposalwasaccepted… (at H1 afterlisting)
–Male, 45 year-old, 69 kg for 1.60 m, Gr 0-
–24 hoursof ICU for CerebralStroke and Anoxia
Bili
ASAT
ALAT
GGT
At Admiss.
30μmol/L
203
470
91
Re LT / Cold Ischemia 4h / 7 RPC
14. Very long post operative course…
12 weeks of ICU and 8 weeks in Hospitalization
15. Actual status at 3 years of FU
•Asymptomatic, heworksin a bank
•ASAT 29, ALAT 100, GGT 83, TP 87%
•Under viread…
Thanksfor yourattention
eric.vibert.pbr@gmail.com
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