Balloon-occluded retrograde transvenous obliteration is feasible for prolonged portosystemic shunts after living donor liver transplantation

Surg Today. 2014 Apr;44(4):633-9. doi: 10.1007/s00595-013-0535-3. Epub 2013 Mar 7.

Abstract

Purposes: The purpose of our study was to evaluate the efficacy of balloon-occluded retrograde transvenous obliteration (B-RTO) in patients after living donor liver transplantation (LDLT).

Methods: Five patients with gastric varices (GVx) and/or liver dysfunction who were treated with B-RTO from January 2001 to December 2007 were enrolled in this study (GVx, n = 2; liver dysfunction, n = 1; both, n = 2). The eradication rate of the GVx, portal vein hemodynamics and improvement of liver function were evaluated.

Results: B-RTO was performed successfully, and the GVx disappeared or decreased markedly in all patients. Recurrence of GVx was not observed during the follow-up. Significantly increased portal vein inflow and improved liver function were observed in all patients.

Conclusions: B-RTO may be an effective treatment for patients after LDLT to prevent bleeding from GVx or to modulate portal vein inflow that is reduced by prolonged large portosystemic shunts.

MeSH terms

  • Aged
  • Balloon Occlusion / methods*
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / therapy*
  • Feasibility Studies
  • Female
  • Humans
  • Liver Diseases / etiology
  • Liver Diseases / therapy*
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Portal Vein / physiopathology
  • Portasystemic Shunt, Surgical / adverse effects*
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Regional Blood Flow