Long-term Outcome of Percutaneous Interventions for Hepatic Venous Outflow Obstruction after Pediatric Living Donor Liver Transplantation: Experience from a Single Institute

Yabuta, Minoru; Shibata, Toshiya; Shibata, Toshinobu; Shinozuka, Ken; Isoda, Hiroyoshi; Okamoto, Shinya; Üemoto, Shinji; Togashi, Kaori

doi:10.1016/j.jvir.2013.07.010

Cited by 27 publications

(57 citation statements)

References 22 publications

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“…Some authors have suggested that a second angioplasty procedure is required when recurrence ensues after a first balloon angioplasty procedure, with stenting being considered appropriate for cases that recur despite a second angioplasty procedure. 8,10,13 In one study, satisfactory results were attained with repeat angioplasty, with no cases of subsequent rupture, thrombosis, or mortality. 13 Thus, repeat angioplasty could be a safe treatment option.…”

Section: Discussionmentioning

confidence: 97%

“…There is no consensus in the literature as to which of the options of balloon angioplasty, balloon angioplasty plus stenting, or primary stenting should be selected for treatment of early-onset HVOO cases. 6,10 Although authors have reported favorable outcomes with primary stenting, they have also advocated that balloon angioplasty is still the best option for early-onset HVOO, suggesting that stents both increase the tendency for thrombosis and cause technical difficulties in the case of repeated liver transplant. 3 In contrast, the rationale of authors advocating avoidance of balloon angioplasty are as follows.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplant: Single Center Experience

Koç

Akbulut²,

Soyer³

et al. 2021

Exp Clin Transplant

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Objectives: In this study, we share our approach for care of patients with hepatic venous outlet obstruction after living-donor liver transplant. Results: Patients ranged in age from 1 to 61 years (24 adults and 11 children). All adult patients had undergone right lobe living-donor liver transplant. In the pediatric group, 8 had undergone left lateral segment and 3 had undergone left lobe living-donor liver transplant. Nineteen adult patients and all 11 pediatric patients underwent hepatic venous reconstruction, with all procedures based on common large-opening drainage models using various vascular graft materials. Development of hepatic venous outlet obstruction occurred at mean posttransplant day 233 ± 298.5 in the adult patients and mean posttransplant day 139 ± 97.8 in the pediatric patients. After development of obstruction, the patients underwent 1-6 sessions (1.5 ± 1.1 sessions) of balloon angioplasty. After the first balloon angioplasty procedure, 25% of the adults and 36.3% of the pediatric patients developed recurrence. The early-onset and late-onset subgroups showed statistically significant differences in serum albumin (P = .01), underlying causes (P < .001), time from transplant to obstruction (P = .02), and time from transplant to last visit (P = .02). The survivor and nonsurvivor subgroups showed statistically significant differences in total bilirubin (P = .03) and time from transplant to last visit (P = .03). Conclusions: Common large-opening reconstruction minimizes hepatic venous outlet obstruction development after living-donor liver transplant. Balloon angioplasty and/or stenting is almost always the first option in the care of this complication. Materials and Methods Key words: Balloon angioplasty, Venous outflow, Venous reconstruction models IntroductionSince the time of the first successful liver transplant in humans (performed by Starzl and colleagues in 1967), liver transplant has emerged as the standard treatment option for a wide array of liver disorders and mainly those related to chronic liver diseases. [1][2][3][4] Although deceased-donor liver transplant (DDLT) constitutes a large percentage of liver transplant procedures performed in Western countries, most liver transplant procedures performed in many of the Asian countries (including Turkey) use organs obtained from living donors (that is, living-donor liver transplant; LDLT). 1 The surgical techniques of DDLT and LDLT differ, as do the posttransplant liver functions resulting from each.One of the most notable differences in the techniques is the reconstruction approach for venous outflow, which is necessary to ensure proper and adequate hepatic drainage. 3 In DDLT, various wide anastomoses are reconstructed between the donor's inferior vena cava (IVC) and the recipient's retrohepatic IVC; this approach lowers the rate of postoperative drainage complications to acceptable levels. In contrast, for LDLT, the reconstruction approach is complicated by the presence of multiple venous orifices in the liver grafts, as well as...

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplant: Single Center Experience

Koç

Akbulut²,

Soyer³

et al. 2021

Exp Clin Transplant

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“…In our reported study [14] , the rates of technical success, primary patency and primary-assisted patency were evaluated. Technical success is defined as success in interventional procedures.…”

Section: Resultsmentioning

confidence: 99%

Interventional radiology for post-transplant anastomotic complications

Shibata¹

2017

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How to cite this article: Shibata T. Interventional radiology for post-transplant anastomotic complications. Hepatoma Res 2017;3:221-7.The effectiveness of percutaneous interventional radiology for anastomotic stricture in hepatic vein, portal vein, and biliary tract after living donor liver transplantation (LDLT) is described. As a number of patients with LDLT are infants < 10-year-old in the study, the first treatment option was balloon dilatation, not primary stenting. However, stent placement was performed in patients with recurrent, repeated stenosis. Key words:Interventional radiology, living donor liver transplantation, balloon dilatation, stent placement ABSTRACTArticle history:

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“…[13] A venogram is performed and the pressure gradient is measured to confirm the diagnosis, usually via a transjugular or transfemoral route (Fig. 5).…”

Section: Hepatic Vein Stenosismentioning

confidence: 99%

The role of interventional radiology in complications after paediatric liver transplantation

Cantrell

2014

S Afr Med J

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Long-term Outcome of Percutaneous Interventions for Hepatic Venous Outflow Obstruction after Pediatric Living Donor Liver Transplantation: Experience from a Single Institute

Abstract: Percutaneous interventions were effective treatments for HVOO after LDLT.

Cited by 27 publications

References 22 publications

Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplant: Single Center Experience

Hepatic Venous Outflow Obstruction After Living-Donor Liver Transplant: Single Center Experience

Interventional radiology for post-transplant anastomotic complications

The role of interventional radiology in complications after paediatric liver transplantation

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