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Br J Anaesth. 2011 April; 106(4): 537–539.
Published online 2011 February 14. doi:  10.1093/bja/aer008
PMCID: PMC3060377
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Two cases of variceal haemorrhage during living-donor liver transplantation


Some patients with cirrhosis experience rupture of venous varices before operation, and liver transplantation is a therapy of last resort for these patients. However, we have experienced two cases of intraoperative rupture in whom no abnormalities of the venous varices were seen on endoscopy before operation. One patient with ruptured gastrointestinal varices was treated by direct surgical ligation and the other with ruptured oesophageal gastric varices, spontaneously recovered with a Sengstaken–Blakemore tube. These cases suggest that acute variceal haemorrhage should always be considered as a possibility during living-donor liver transplantation in patients with a history of upper gastrointestinal bleeding. Careful observation of the nasogastic tube is important during clamping of the hepatic portal vein.

Keywords: living-donor liver transplantation, portal hypertension, variceal haemorrhage

Articles from BJA: British Journal of Anaesthesia are provided here courtesy of Oxford University Press