-transparent.png){kind=logo}
Variceal hemorrhage is frequently a lethal event. Mortality among patients who have bled is high, with survival over the short term of only 25% to 50%. We retrospectively reviewed the records of 177 patients in whom variceal bleeding was treated with variceal sclerosis during a 5-year period from 1981 to 1986. All patients were treated by freehand injection of 25% sodium morrhuate with 35% dextrose, 4 ml per injection, through a fiberoptic endoscope. Of this group, 46 patients were treated with sclerosis followed by liver transplantation (group 1). These were compared to 36 nonalcoholic Child's class B and C patients treated with sclerosis alone (group 2). Survival at 4 years was poor in group 2 (17%). Liver failure and continued gastrointestinal bleeding were the most frequent causes of death. Survival among the liver-transplant group was significantly better (73%, p less than 0.001). Causes of death in this group were primarily due to sepsis, often in the setting of acute graft rejection. Group 1 patients were younger (39.8 +/- 10.8 vs 49.8 +/- 16.5 years, p less than 0.01); this difference is influenced by the deliberate selection of younger patients for liver transplantation. We conclude that sclerotherapy followed by liver transplantation significantly improves survival compared to conventional therapy in selected patients with advanced liver disease and portal hypertension. Donor organ availability will seriously limit the applicability of this approach to patients with bleeding esophageal varices.
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
December 1978,
Ugeskrift for laeger,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
May 1983,
Virginia medical,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
January 1984,
Annual review of medicine,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
April 2001,
Il Giornale di chirurgia,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
October 1988,
Surgery,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
January 1980,
Cardiovascular and interventional radiology,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
May 1986,
Journal of the Medical Association of Thailand = Chotmaihet thangphaet,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
June 1986,
Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
March 1986,
Harefuah,
K O Garrett, and
J J Reilly, and
R R Schade, and
D H van Thiel
September 1983,
The Journal of the Arkansas Medical Society,
