Endovascular treatment of hepatic venous outflow obstruction after living-donor liver transplantation

Gi Young Ko, Kyu Bo Sung, Hyun Ki Yoon, Jeong Ho Kim, Ho Young Song, Tae-Seok Seo, Sung Gyu Lee

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

PURPOSE: To evaluate the effectiveness and safety of percutaneous interventional management of hepatic venous outflow obstruction after living-donor liver transplantation (LDLT). MATERIALS AND METHODS: Percutaneous balloon angioplasty (n = 5) and stent placement (n = 22) were attempted in 27 patients with hepatic venous outflow obstruction. Patient follow-up included clinical and laboratory data collection, Doppler ultrasonography (US), hepatic venography, and computed tomography. The following parameters were documented retrospectively: technical success and complications, clinical improvement, and recurrence. Technical success was defined as elimination or successful reduction of pressure gradients across the stenosis and clinical success was defined as amelioration of presenting signs. Recurrence was defined as relapse of clinical signs with hepatic venous anastomotic restenosis on Doppler US. RESULTS: Technical success was achieved in all patients. The mean pressure gradients across the stenoses before and after the procedure were 10.6 mm Hg ± 6.4 (range, 3-39 mm Hg) and 2.4 mm Hg ± 2.6 (range, 0-8 mm Hg), respectively (P < .001). Three of the five patients who underwent balloon angioplasty developed recurrent stenosis 1-5 weeks after the procedure. These patients underwent repeat balloon angioplasty, and two of them eventually underwent stent placement (n = 1) or surgical repositioning (n = 1) of the graft. Three of the 22 patients who underwent stent placement required a second stent placement procedure because of malpositioning, partial migration, and acute angulation. During the mean follow-up period of 49 weeks ± 47 (range, 3-214 wk), clinical success was achieved in 20 of 27 patients (73%). CONCLUSION: Percutaneous interventional management is an effective and safe adjunct for the treatment of hepatic venous outflow obstruction after LDLT.

Original languageEnglish
Pages (from-to)591-599
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume13
Issue number6
DOIs
Publication statusPublished - 2002 Jan 1
Externally publishedYes

Fingerprint

Budd-Chiari Syndrome
Living Donors
Liver Transplantation
Stents
Balloon Angioplasty
Doppler Ultrasonography
Pathologic Constriction
Recurrence
Therapeutics
Pressure
Phlebography
Liver
Tomography
Transplants
Safety

Keywords

  • Hepatic veins
  • Liver, transplantation
  • Stenosis or obstruction
  • Stents and prostheses

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Endovascular treatment of hepatic venous outflow obstruction after living-donor liver transplantation. / Ko, Gi Young; Sung, Kyu Bo; Yoon, Hyun Ki; Kim, Jeong Ho; Song, Ho Young; Seo, Tae-Seok; Lee, Sung Gyu.

In: Journal of Vascular and Interventional Radiology, Vol. 13, No. 6, 01.01.2002, p. 591-599.

Research output: Contribution to journalArticle

Ko, Gi Young ; Sung, Kyu Bo ; Yoon, Hyun Ki ; Kim, Jeong Ho ; Song, Ho Young ; Seo, Tae-Seok ; Lee, Sung Gyu. / Endovascular treatment of hepatic venous outflow obstruction after living-donor liver transplantation. In: Journal of Vascular and Interventional Radiology. 2002 ; Vol. 13, No. 6. pp. 591-599.
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abstract = "PURPOSE: To evaluate the effectiveness and safety of percutaneous interventional management of hepatic venous outflow obstruction after living-donor liver transplantation (LDLT). MATERIALS AND METHODS: Percutaneous balloon angioplasty (n = 5) and stent placement (n = 22) were attempted in 27 patients with hepatic venous outflow obstruction. Patient follow-up included clinical and laboratory data collection, Doppler ultrasonography (US), hepatic venography, and computed tomography. The following parameters were documented retrospectively: technical success and complications, clinical improvement, and recurrence. Technical success was defined as elimination or successful reduction of pressure gradients across the stenosis and clinical success was defined as amelioration of presenting signs. Recurrence was defined as relapse of clinical signs with hepatic venous anastomotic restenosis on Doppler US. RESULTS: Technical success was achieved in all patients. The mean pressure gradients across the stenoses before and after the procedure were 10.6 mm Hg ± 6.4 (range, 3-39 mm Hg) and 2.4 mm Hg ± 2.6 (range, 0-8 mm Hg), respectively (P < .001). Three of the five patients who underwent balloon angioplasty developed recurrent stenosis 1-5 weeks after the procedure. These patients underwent repeat balloon angioplasty, and two of them eventually underwent stent placement (n = 1) or surgical repositioning (n = 1) of the graft. Three of the 22 patients who underwent stent placement required a second stent placement procedure because of malpositioning, partial migration, and acute angulation. During the mean follow-up period of 49 weeks ± 47 (range, 3-214 wk), clinical success was achieved in 20 of 27 patients (73{\%}). CONCLUSION: Percutaneous interventional management is an effective and safe adjunct for the treatment of hepatic venous outflow obstruction after LDLT.",
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AB - PURPOSE: To evaluate the effectiveness and safety of percutaneous interventional management of hepatic venous outflow obstruction after living-donor liver transplantation (LDLT). MATERIALS AND METHODS: Percutaneous balloon angioplasty (n = 5) and stent placement (n = 22) were attempted in 27 patients with hepatic venous outflow obstruction. Patient follow-up included clinical and laboratory data collection, Doppler ultrasonography (US), hepatic venography, and computed tomography. The following parameters were documented retrospectively: technical success and complications, clinical improvement, and recurrence. Technical success was defined as elimination or successful reduction of pressure gradients across the stenosis and clinical success was defined as amelioration of presenting signs. Recurrence was defined as relapse of clinical signs with hepatic venous anastomotic restenosis on Doppler US. RESULTS: Technical success was achieved in all patients. The mean pressure gradients across the stenoses before and after the procedure were 10.6 mm Hg ± 6.4 (range, 3-39 mm Hg) and 2.4 mm Hg ± 2.6 (range, 0-8 mm Hg), respectively (P < .001). Three of the five patients who underwent balloon angioplasty developed recurrent stenosis 1-5 weeks after the procedure. These patients underwent repeat balloon angioplasty, and two of them eventually underwent stent placement (n = 1) or surgical repositioning (n = 1) of the graft. Three of the 22 patients who underwent stent placement required a second stent placement procedure because of malpositioning, partial migration, and acute angulation. During the mean follow-up period of 49 weeks ± 47 (range, 3-214 wk), clinical success was achieved in 20 of 27 patients (73%). CONCLUSION: Percutaneous interventional management is an effective and safe adjunct for the treatment of hepatic venous outflow obstruction after LDLT.

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