Table 2.
Main Cause of Death Within First Year of 15 Patients in the Recent Colorado Series of 30
| OT number and Age (yr) |
Days survival |
Original disease | Pathology of homografts | Main cause of death |
|---|---|---|---|---|
| 118 (24) | 12 (10 + 2)a |
Alpha1-antitrypsin deficiency | 1. Central and midzonal necrosis 2. Massive necrosis |
Recipient portal vein thrombosed, grafts could not be vascularized; liver failure; variceal bleeding |
| 119 (23) | 33 | Sclerosing cholangitis; ulcerative colitis | Biliary obstruction, intrahepatic sludge formation, and cholangitis; no rejection |
Obstructed cholecystojejunostomy converted to choledochojejunostomy; subsequent rupture of mycotic hepatic artery aneurysm into jejunum |
| 121 (32) | 163 | Hepatoma | HBsAg hepatitis and diffuse interstitial fibrosis; chronic rejection with arterial narrowing and bile ductule loss |
Brain injury after falling from bed; inanition and pneumonitis thereafter |
| 122 (28) | 131 | Chronic aggressive hepatitis | Chronic rejection | Pneumococcal meningitis; liver failure; liver abscesses |
| 123 (40) | 22 | Chronic aggressive hepatitis | Nonspecific centrilobular necrosis; no rejection | Liver too large to permit abdominal wound closure; pneumonitis; bone marrow depression |
| 124 (41) | 203 | Chronic aggressive hepatitis | Centrilobular and midzonal necrosis; early chronic rejection |
Liver failure; portal vein thrombosis; bleeding peptic ulcer; bleeding varices |
| 127 (5.5) | 9 | ? Alpha1-antitrypsin deficiency (PIMZ) | Centrilobular necrosis; no rejection | Intractable heart failure and pulmonary edema; congenital heart disease; hepatic artery thrombosis |
| 128 (3.5) | 174 | Biliary atresia | Cellular rejection | Hypertension, heart failure, pneumonitis, steroid toxicity was price of graft function |
| 129 (14) | 175 | Chronic aggressive hepatitis of hepatic remnant after resection |
Chronic rejection | Small intestinal injury led to uncontrolled fistula; eventual liver failure |
| 130 (35) | 40 | Alcoholic cirrhosis | Centrilobular cholestasis; ? rejection | Leak choledochocholedochostomy; disseminated candidiasis |
| 131 (46) | 2 | Alcoholic cirrhosis | Widespread necrosis | Recipient portal vein thrombosed and recannulized; clotted postop; liver failure and variceal hemorrhage |
| 132 (1) | 166 | Biliary atresia | Centrilobular cholestasis; hepatocyte atrophy and fatty infiltration; no rejection |
Steroid toxicity was price of graft function; pneumonitis |
| 134 (1.5) | 110 (69 + 41)a |
Type IV glycogen storage | 1. Chronic rejection 2. Necrotic graft (acute rejection in biopsy 25 days earlier) |
Liver failure after both grafts; infection |
| 136 (43) | 33 | Sclerosing cholangitis; ulcerative colitis | Centrilobular necrosis; no rejection | Leak Roux-Y anastomosis; infection |
| 138 (42) | 108 | Sclerosing cholangitis; ulcerative colitis | Chronic cholangitis; no rejection | Leak of colonic anastomosis after emergency colectomy; infection; liver failure; pulmonary failure (massive CMV infection) |
a
Time residence of successive grafts.