{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:51:57Z","timestamp":1759179117493,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multivisceral transplant (MVT) for cirrhosis, and portomesenteric vein thrombosis (PVT), is fraught with life\u2010threatening thrombo\u2010hemorrhagic complications. Embolization of native viscera has been attempted in a handful of cases with mixed results. We carried out a comparative analysis of angiographic, intra\u2010operative, and pathological findings in three recipients of MVT who were deemed exceptionally high hemorrhagic risk and therefore underwent preoperative visceral embolization. All recipients were male with cirrhosis, PVT, and a surgical history indicative of diffuse visceral adhesions; status post\u2010liver transplantation (n\u00a0=\u00a02) and proctocolectomy (n\u00a0=\u00a01). The first patient had two Amplatzer II embolization plugs placed 2\u00a0cm from the origins of celiac and superior mesenteric (SMA) arteries. Distal migration of the celiac plug into gastroduodenal artery (GDA) and ensuing ischemia reperfusion injury, presumably contributed to severe disseminated intravascular coagulation (DIC) and intra\u2010operative mortality. In the other two recipients, distal Gelfoam embolization of the SMA, GDA, and splenic arteries was performed, and although remarkable hemorrhage and coagulopathy occurred, embolization, undoubtedly, facilitated exenteration and improved outcomes. Pathologic examination in these cases confirmed ischemic necrosis of eviscerated bowel. In conclusion, liver\u2010sparing, preoperative distal embolization of native viscera with Gelfoam is beneficial, but entails several pitfalls. It should currently be reserved for MVT recipients who otherwise are at unacceptably high risk.<\/jats:p>","DOI":"10.1111\/ctr.13645","type":"journal-article","created":{"date-parts":[[2019,6,23]],"date-time":"2019-06-23T11:43:41Z","timestamp":1561290221000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Visceral arterial embolization prior to multivisceral transplantation in recipient with cirrhosis, extensive portomesenteric thrombosis, and hostile abdomen: Performance and outcome analysis"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-1866","authenticated-orcid":false,"given":"Ramona","family":"Nicolau\u2010Raducu","sequence":"first","affiliation":[{"name":"Department of Anesthesia University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Livingstone","sequence":"additional","affiliation":[{"name":"Department of Anesthesia University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Salsamendi","sequence":"additional","affiliation":[{"name":"Department of Interventional and Vascular Radiology University of Miami Miller School of Medicine Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiago","family":"Beduschi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Vianna","sequence":"additional","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akin","family":"Tekin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennaro","family":"Selvaggi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Miami Transplant Institute University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-2743","authenticated-orcid":false,"given":"Yehuda","family":"Raveh","sequence":"additional","affiliation":[{"name":"Department of Anesthesia University of Miami\/Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_8_2_1","DOI":"10.1111\/tri.13281"},{"issue":"6","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"S25","DOI":"10.1097\/01.tp.0000521309.13589.b6","article-title":"Use of arterial embolisation to facilitate exenteration during multivisceral and small bowel","volume":"101","author":"Butler A","year":"2017","journal-title":"Transplantation"},{"doi-asserted-by":"publisher","key":"e_1_2_8_4_1","DOI":"10.1097\/TP.0b013e3182534315"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1111\/ajt.13336"},{"issue":"3","key":"e_1_2_8_6_1","first-page":"1407","article-title":"Evolution of surgical techniques in clinical intestinal transplantation","volume":"26","author":"Tzakis A","year":"1994","journal-title":"Transpl 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