Stenoses of vascular anastomoses after hepatic transplantation: treatment with balloon angioplasty.

Raby, Nigel; Karani, John; Thomas, S; O’Grady, J; Williams, Robin

doi:10.2214/ajr.157.1.1828649

Cited by 178 publications

(109 citation statements)

References 2 publications

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“…[1][2][3][4][5][6] After performing these procedures, life-threatening bleeding may occur from transhepatic tracts and, as a result, lead to morbidity and mortality. According to the literature, various embolic materials, including gelatin sponge particles, biological tissue adhesives, coils and plugs, have been utilized to prevent bleeding from the tracts.…”

mentioning

confidence: 99%

Embolization of percutaneous transhepatic portal venous access tract withN-butyl cyanoacrylate

Park¹,

Kim²,

Kim³

et al. 2014

BJR

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mentioning

confidence: 99%

Embolization of percutaneous transhepatic portal venous access tract withN-butyl cyanoacrylate

Park¹,

Kim²,

Kim³

et al. 2014

BJR

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“…This is not usually the case with adult-to-adult transplants [12]. Measurement of pressure gradient across the stenosis is a reliable diagnostic tool, but the required angiographic procedure is an invasive one [13]. An alternative way of detecting flow abnormalities is by portal flow volume measurement using Doppler ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…In our experience, the mean velocity of the portal flow was 38.63 f 8.31 cm/s and the portal blood flow volume per body weight was 22.54 f 8.27 ml/min per kg in non-complicated vascular patients, with 9 ml/min per kg being defined as the lowest limit of acceptable portal flow volume during and after transplantation [5,15]. In cases where low portal inflow is associated with suspected portal hypertension syndrome, angiographic hemodynamic confirmation or indirect pressure gradient measurement (hepatic wedge and splenic direct pulp pressure) is indicated [13].…”

Section: Discussionmentioning

confidence: 99%

Interventional radiologic procedures in liver transplantation

Cheng

Chen

Huang

et al. 2001

Transplant International

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Postoperative biliary and vascular complications contribute significantly to morbidity and mortality in liver transplantation. Interventional radiologists are an integral part of the multidisciplinary team necessary for optimizing the management of these complications. During a 15-year period, 39 cadaveric and 25 living related liver transplantations were performed at the Chang Gung Memorial hospital, Taiwan. Of 64 liver transplant recipients, 9 (3 adult and 6 pediatric) underwent 13 interventional radiological procedures for the treatment of biliary sludge-casts (n = 2), bile duct occlusion or stenosis ( n = 2), hepatic veins thrombosis (n = l), hepatic veins stenosis ( n = l), portal vein stenosis with splenorenal shunting (n = l), biloma (n = l), and infected fluid collection or ascites (n = 4). Antegrade or retrograde interventional approach was used to successfully treat all biliary complications, and all percutaneous drainage procedures were effective in the control of intra-abdominal fluid collections. Portal vein stenosis was treated by balloon dilatation, and the associated splenorenal shunt was closed by metallic coil embolization via transhepatic catheterization of the portal vein. Hepatic vein stenosis was effectively treated by balloon dilatation and expandable metallic stent deployment via transfemoral and jugular venous approaches, respectively. Hepatic vein thrombosis was only partially lysed by transvenous streptokinase administration, and surgical thrombectomy was needed to achieve complete recanalization. The total success rate of the interventional procedures was 92 % with no procedure-related complications. The overall survival rate in this series is 89 %, and all patients who underwent living related liver transplantation maintain to date a 100 YO survival rate. We can conclude that interventional radiological procedures are very useful for managing biliary and vascular complications after liver transplantation. These techniques provide a cure in most situations, thus obviating the need for further surgical intervention or re-transplantation.

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“…Therefore, the terminal loop of ileum was exposed through a McBurney incision [2]. These techniques have successfully been performed, and portal vein stenosis substantially improved thereafter [2,3,10,13,14].…”

Section: Discussionmentioning

confidence: 99%

Portal vein angioplasty using a transjugular, intrahepatic approach for treatment of extrahepatic portal vein stenosis after liver transplantation

Glanemann¹,

Settmacher²,

Langrehr³

et al. 2001

Transplant Int

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Symptomatic portal vein stenosis is an uncommon complication after liver transplantation. Portal vein angioplasty has been successfully established for treatment of portal vein stenosis using mesenteric or percutaneous, transhepatic approaches. We herein report on a patient who suffered from variceal bleeding due to portal hypertension 3 months after liver transplantation. After successful endoscopic sclerotherapy, an extrahepatic portal vein stenosis was diagnosed, and portal vein angioplasty was considered as primary therapeutic option. Instead of mesenteric or percutaneous, transhepatic approaches, we adopted a transjugular, intrahepatic access to introduce a 14-mm balloon cath-

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Stenoses of vascular anastomoses after hepatic transplantation: treatment with balloon angioplasty.

Cited by 178 publications

References 2 publications

Embolization of percutaneous transhepatic portal venous access tract withN-butyl cyanoacrylate

Embolization of percutaneous transhepatic portal venous access tract withN-butyl cyanoacrylate

Interventional radiologic procedures in liver transplantation

Portal vein angioplasty using a transjugular, intrahepatic approach for treatment of extrahepatic portal vein stenosis after liver transplantation

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