Endovascular treatment of hepatic venous outflow obstruction after piggyback technique liver transplantation.

Abstract:

BACKGROUND:The piggyback technique of orthotopic liver transplantation is an attractive alternative that preserves the recipient inferior vena cava and allows uninterrupted venous blood return during the anhepatic phase. As with other transplantation techniques, the vascular anastomoses required by the piggyback technique can develop strictures. METHODS:Review of records of 264 piggyback transplantations revealed two cases of delayed-onset hepatic venous obstruction from anastomotic strictures. Both patients also had symptoms of inferior vena cava obstruction, with azotemia and lower extremity edema. Both patients were treated percutaneously with balloon-expandable stents. RESULTS:Rapid, dramatic resolution of symptoms was achieved in both patients. Patients remain completely asymptomatic at 39 and 3 months of follow-up. CONCLUSIONS:Hepatic venous anastomotic strictures in recipients of piggyback technique transplants are a very uncommon complication. They may be easily and effectively treated by minimally invasive endovascular intervention.

journal_name

Transplantation

journal_title

Transplantation

authors

Sze DY,Semba CP,Razavi MK,Kee ST,Dake MD

doi

10.1097/00007890-199908150-00018

subject

Has Abstract

pub_date

1999-08-15 00:00:00

pages

446-9

issue

3

eissn

0041-1337

issn

1534-6080

journal_volume

68

pub_type

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