Vascular Complications in Hepatic Transplantation: Single-Center Experience in 14 Years

Akun, E.; Yaprak, Onur; Killi, Refik; Balci, N. Cem; Tokat, Yaman; Yüzer, Yıldıray

doi:10.1016/j.transproceed.2012.02.027

Cited by 38 publications

(29 citation statements)

References 20 publications

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“…A hepatic venous outflow obstruction is a relatively rare but life‐threatening complication of liver transplantation. The reported incidence of hepatic venous outflow obstruction following liver transplantation ranges from 0.8% to 9.5% . Recently, the number of LDLTs is rapidly increasing, and the incidence of hepatic venous outflow obstruction is not infrequent after an LDLT because of the necessity of multiple hepatic venous anastomoses in this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The reported incidence of hepatic venous outflow obstruction following liver transplantation ranges from 0.8% to 9.5%. (5,9,11,12) Recently, the number of LDLTs is rapidly increasing, and the incidence of hepatic venous outflow obstruction is not infrequent after an LDLT because of the necessity of multiple hepatic venous anastomoses in this procedure. Early diagnosis and adequate treatment of a hepatic venous outflow obstruction is important for good graft function and patient survival.…”

Section: Discussionmentioning

confidence: 99%

“…Vascular complications are life‐threatening when they develop after liver transplantation . A hepatic venous outflow abnormality is one of the most crucial vascular complications, leading to refractory graft dysfunction from liver congestion and causing graft loss and mortality as high as 17%‐24% . The incidence of hepatic venous outflow abnormality has been reported to be 0.8%‐9.5% after liver transplantation …”

mentioning

confidence: 99%

“…(4)(5)(6)(7)(8) A hepatic venous outflow abnormality is one of the most crucial vascular complications, leading to refractory graft dysfunction from liver congestion and causing graft loss and mortality as high as 17%-24%. (9,10) The incidence of hepatic venous outflow abnormality has been reported to be 0.8%-9.5% after liver transplantation. (5,9,11,12) Primary stent placement is a safe and effective treatment modality to treat a posttransplant hepatic venous outflow abnormality.…”

mentioning

confidence: 99%

“…(9,10) The incidence of hepatic venous outflow abnormality has been reported to be 0.8%-9.5% after liver transplantation. (5,9,11,12) Primary stent placement is a safe and effective treatment modality to treat a posttransplant hepatic venous outflow abnormality. There are several studies with good short-term to midterm results following primary stent placement with a mean follow-up period of 12-72 months.…”

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confidence: 99%

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Longterm outcomes of stent placement for hepatic venous outflow obstruction in adult liver transplantation recipients

Chu

Kim

et al. 2016

Liver Transpl

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The purpose of this study was to evaluate the longterm outcomes of stent placement for a hepatic venous outflow obstruction in adult liver transplantation recipients. From June 2002 to March 2014, 23 patients were confirmed to have a hepatic venous outflow obstruction after liver transplantation (18 of 789 living donors [2.3%] and 5 of 449 deceased donors [1.1%]) at our institute. Among these patients, stent placement was needed for 16 stenotic lesions in 15 patients (12 males, 3 females; mean age, 51.7 years). The parameters that were documented retrospectively were technical success, clinical success, complications, recurrence, and the patency of the stent. The technical success rate was 100% (16/16). Clinical success was achieved in 11 of the 15 patients (73.3%). A major complication occurred in only 1 patient-a hepatic vein laceration during the navigation of the occluded segment. The median follow-up period was 33.5 months (range, 0.5-129.3 months), and the overall 1-, 3-, and 5-year primary patency rates of the stent were all 93.8%. One case of occlusion of the stent without clinical signs and symptoms was observed 5 days after the initial procedure. In this patient, the stent was recanalized by balloon angioplasty and showed patent lumen for 48 months of the subsequent follow-up period. In conclusion, stent placement is a safe and effective treatment modality with favorable longterm outcomes to treat hepatic venous outflow obstruction in adult liver transplantation recipients. Liver Transplantation 22 1554-1561 2016 AASLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Longterm outcomes of stent placement for hepatic venous outflow obstruction in adult liver transplantation recipients

Chu

Kim

et al. 2016

Liver Transpl

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Smoothing the path: Reducing biliary complications, addressing small-for-size syndrome, and making other adaptations to decrease the risk for living donor liver transplant recipients

Soin

2012

Liver Transpl

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Key Points 1. Over the course of the past 2 decades, living donor liver transplantation (LDLT) has become increasingly successful because many of the technical issues plaguing it have been resolved. 2. Although donor safety remains a concern, most challenges related to the recipient's surgery are now better understood, and they appear surmountable. 3. The following concepts need to be addressed for optimal recipient outcomes to be achieved: a. Reduction of the risk of small‐for‐size syndrome in LDLT (ie, the management of 4 factors: the recipient status, the portal pressure and inflow, the venous outflow, and the graft‐to‐recipient weight ratio/graft quality). b. Reduction of the risk of surgical complications (biliary complications, reconstitution of the middle hepatic vein outflow in the right lobe graft, and safe hepatic artery and portal vein reconstruction). c. Other adaptations for improving recipient outcomes (adaptations related to LDLT and adaptations common to deceased donor liver transplantation and LDLT). Liver Transpl, 2012. © 2012 AASLD.

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Hepatobiliary Tract Infections

Merola

Mocharla

Jow

et al. 2019

Principles and Practice of Transplant Infectious Diseases

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Vascular Complications in Hepatic Transplantation: Single-Center Experience in 14 Years

Cited by 38 publications

References 20 publications

Longterm outcomes of stent placement for hepatic venous outflow obstruction in adult liver transplantation recipients

Longterm outcomes of stent placement for hepatic venous outflow obstruction in adult liver transplantation recipients

Smoothing the path: Reducing biliary complications, addressing small-for-size syndrome, and making other adaptations to decrease the risk for living donor liver transplant recipients

Hepatobiliary Tract Infections

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