Hepatic venous outflow obstruction after adult living donor liver transplantation.
Liver Transpl
; 29(12): 1292-1303, 2023 12 01.
Article
em En
| MEDLINE
| ID: mdl-37540170
ABSTRACT
Hepatic venous outflow obstruction (HVOO) is a rare but critical vascular complication after adult living donor liver transplantation. We categorized HVOOs according to their morphology (anastomotic stenosis, kinking, and intrahepatic stenosis) and onset (early-onset < 3 mo vs. late-onset ≥ 3 mo). Overall, 16/324 (4.9%) patients developed HVOO between 2000 and 2020. Fifteen patients underwent interventional radiology. Of the 16 hepatic venous anastomoses within these 15 patients, 12 were anastomotic stenosis, 2 were kinking, and 2 were intrahepatic stenoses. All of the kinking and intrahepatic stenoses required stent placement, but most of the anastomotic stenoses (11/12, 92%) were successfully managed with balloon angioplasty, which avoided stent placement. Graft survival tended to be worse for patients with late-onset HVOO than early-onset HVOO (40% vs. 69.3% at 5 y, p = 0.162) despite successful interventional radiology. In conclusion, repeat balloon angioplasty can be considered for simple anastomotic stenosis, but stent placement is recommended for kinking or intrahepatic stenosis. Close follow-up is recommended in patients with late-onset HVOO even after successful treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Fígado
/
Angioplastia com Balão
/
Síndrome de Budd-Chiari
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Liver Transpl
Assunto da revista:
GASTROENTEROLOGIA
/
TRANSPLANTE
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Japão