This report discusses the pathophysiology of and therapeutic methods to address hepatic vein anastomotic stricture after living donor liver transplantation (LDLT). From 1994 to 2002, our 15 LDLTs using the lateral segments or left lobes included four recipients who experienced 28 occurrences of this complication after the operation. The period between LDLT and the first stricture was 4.0 +/- 1.2 months. The age of the affected recipients (31.0 +/- 8.2 years) was significantly higher than that of the nonaffected patients (7.0 +/- 4.1 years, P < .05). Graft liver/standard liver volume ratio was 39.1% +/- 3.8% in the former and 77.9% +/- 12.7% in the latter cases (P < .05). Initial symptoms of stricture were ascites (42.9%), abdominal distention (42.9%), liver enzyme elevation (10.7%), and gastrointestinal bleeding (3.6%). In addition, 14 of 28 stricture cases (50%) showed increased blood trough levels of tacrolimus. Doppler ultrasonography was used for diagnosis, and balloon dilatations performed in all stricture patients, thereby hepatic significantly reducing venous blood pressure from 33.5 +/- 1.7 to 20.3 +/- 1.5 cmH2O. All patients finally resolved the strictures after several treatments. The stricture after LDLT was associated with small-for-size grafts, suggesting that liver regeneration may lead to anatomical changes and strictures. Since tacrolimus is metabolized by the liver, its blood trough level is one initial symptoms of stricture. Balloon dilatation was useful and safe as the treatment, while problems have been reported after stent insertion in the hepatic vein.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.transproceed.2004.08.066 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Value of Spleen Dynamic Contrast-enhanced Ultrasound Parameters in Predicting Hepatic Vein Pressure Gradient for Patients With Liver Cirrhosis.
J Clin Gastroenterol
January 2025
The Third Central Hospital of Tianjin, Hedong District.
Goals: To explore dynamic contrast-enhanced ultrasound (CEUS) parameters in predicting hepatic vein pressure gradient (HVPG) for patients with liver cirrhosis (LC).
Background: Noninvasive diagnosis of HVPG remains a challenge.
Study: This prospective study included patients with LC undergoing hepatic vein catheterization and pressure measurement at the hospital from May 2021 to January 2023.
Machine learning prediction of hepatic encephalopathy for long-term survival after transjugular intrahepatic portosystemic shunt in acute variceal bleeding.
World J Gastroenterol
January 2025
Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510151, Guangdong Province, China.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for managing complications of portal hypertension, particularly acute variceal bleeding (AVB). While effective in reducing portal pressure and preventing rebleeding, TIPS is associated with a considerable risk of overt hepatic encephalopathy (OHE), a complication that significantly elevates mortality rates.
Aim: To develop a machine learning (ML) model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.
Prediction of posthepatectomy liver failure in patients with hepatocellular carcinoma through ultrasound elastography.
World J Gastroenterol
January 2025
Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China.
In this article, we comment on the article by Cheng published in recently. Posthepatectomy liver failure (PHLF) remains a leading cause of hepatectomy-related mortality and can be evaluated according to liver reserve function. Liver stiffness (LS) measured by ultrasonic elastography and spleen area demonstrate a strong correlation with hepatic proliferation, fibrosis, and portal vein congestion, thus indirectly reflecting liver reserve function.
View Article and Find Full Text PDFA rare, asymptomatic case of an extrahepatic portocaval shunt between the posterior aspect of the portal vein and the inferior vena cava.
Surg Radiol Anat
January 2025
Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, 286-8520, Chiba, Japan.
Purpose: We present the case of a rare extrahepatic portocaval shunt that resulted in communication of the portal vein and the inferior vena cava (IVC) at the level between two right renal veins that was incidentally diagnosed with contrast-enhanced computed tomography (CECT) in an asymptomatic patient.
Methods: A woman in her sixties with abdominal pain and diarrhea of unclear origin underwent exploratory abdominal CECT.
Results: The CECT incidentally revealed an extrahepatic portocaval shunt, whereby a vessel arising from the portal vein superior to the confluence of the superior mesenteric and splenic veins drained into the posterior aspect of the IVC between two right renal veins.
Robotic Anatomical Segment VIII Resection for Hepatocellular Carcinoma Using the Scissor Hepatectomy Technique.
Ann Surg Oncol
January 2025
Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany.
Background: Robotic hepatectomy has been increasingly adopted for the treatment of hepatocellular carcinoma (HCC). However, the ideal technique of parenchymal transection in robotic hepatectomy has been a matter of ongoing debate in literature.
Patients And Methods: In this video, we demonstrate the technique of robotic anatomical segment VIII resection using the scissor hepatectomy technique for parenchymal transection on a 75-year-old male patient with a solitary HCC lesion.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!