Thoracoabdominal bypass graft with liver retransplantation for the treatment of a pseudoaneurysm of the supraceliac aorta after liver transplantation

Pseudoaneurysm following liver transplantation is a rare but life-threateni ng complication. Treatment is directed towards control of fatal bleeding. L igation with or without revascularization of the graft is the treatment of choice. When revascularization is not possible, or the liver does not toler ate the arterial blood deprivation retransplantation is the only option. We report a case of a 14-month-old girl who developed a pseudoaneurysm at the anastomosis between the recipient supraceliac aorta and the donor graft. T he pseudoaneurysm was excised and the aorta was ligated above and below it. An extra-anatomical thoracoabdominal arterial graft was used to provide ar terial blood supply to the lower torso and also to arterialize a new orthot opic liver graft. This is the first reported case of the use of thoracoabdo minal jump graft to vascularize a transplanted liver.