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

Liver Transpl. 2016 Nov;22(11):1554-1561. doi: 10.1002/lt.24598.

Abstract

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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Angioplasty, Balloon
  • Budd-Chiari Syndrome / diagnostic imaging
  • Budd-Chiari Syndrome / etiology
  • Budd-Chiari Syndrome / surgery*
  • Female
  • Follow-Up Studies
  • Hepatic Veins / injuries
  • Humans
  • Lacerations / etiology
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Phlebography
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Recurrence
  • Retrospective Studies
  • Stents* / adverse effects
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler
  • Vascular Patency*