Objectives: Adequate venous outflow is one of the most important factors responsible for optimal graft function in liver transplantation. Thrombosis of the inferior vena cava in cases of Budd-Chiari syndrome poses a major challenge to a transplant surgeon in establishing proper graft outflow. In deceased donor liver transplant, this problem can be dealt with relative ease as the liver graft includes donor inferior vena cava. However, this is not the case in living donor liver transplant. We present our findings of living donor liver transplant for Budd-Chiari syndrome and discuss techniques that have helped overcome this unique problem without the need for complete inferior vena cava replacement.
Materials And Methods: Our retrospective analysis included living donor liver transplant recipients from November 2006 to March 2020 at our center and selected patients who underwent this transplant for Budd-Chiari syndrome. We studied the extent and severity of inferior vena cava involvement in these cases. We developed a classification that not only helped to stratify patterns of venacaval disease but also helped to plan the surgical technique. The role of interventional radiology combined with surgery in management of extensive inferior vena cava stenosis was studied.
Results: Among 2952 cases of liver transplant in our unit from November 2006 to March 2020, 36 patients had Budd-Chiari syndrome; 21 had significant level of inferior vena cava thrombosis, which was managed with inferior vena cava thrombectomy with either patchplasty (n = 20) or segmental replacement (n = 1). None of our patients showed recurrence of primary disease during the median follow-up of 36 months (range, 8-158 mo).
Conclusions: Establishment of adequate venous ouflow in thrombosed inferior vena cava is possible with proper planning of surgical technique and timely involvement of interventional radiology-guided interventions in patients with Budd-Chiari syndrome.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.6002/ect.2020.0541 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Neonatal Seizures as a First Sign of Inferior Vena Cava Thrombosis: Diagnostic and Therapeutic Challenges.
Turk Arch Pediatr
January 2025
Neonatal Care Unit, Unidade Local de Saúde de Braga, Braga, Portugal.
Inferior vena cava diameter in patients with chronic heart failure and chronic kidney disease: a retrospective study.
Eur J Med Res
January 2025
Medical Big Data Research Center, Medical Innovation Research Division, Chinese PLA General Hospital, 28 Fuxing RD., Beijing, 100853, China.
Background: Chronic kidney disease (CKD) carries the highest population attributable risk for mortality among all comorbidities in chronic heart failure (CHF). No studies about the association between inferior vena cava (IVC) diameter and all-cause mortality in patients with the comorbidity of CKD and CHF has been published.
Methods: In this retrospective cohort study, a total of 1327 patients with CHF and CKD were included.
Trend, clinical characteristics, and pregnancy outcomes of pregnancy associated venous thromboembolism: a retrospective analysis of nearly 10 years.
J Matern Fetal Neonatal Med
December 2025
Department of Vascular Surgery & Interventional Therapy, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Background: Pregnancy-associated venous thromboembolism (PA-VTE) seriously threatens maternal health. We aimed to investigate the clinical characteristics, risk factors, treatments, and pregnancy outcomes to better prevent and treat PA-VTE.
Methods: PA-VTE patients were selected from 171,898 women who were registered in the Department of Obstetrics of Fujian Maternity and Child Health Hospital from January 2014 to August 2023 and delivered to calculate the incidence.
Current Concepts in Fluid Resuscitation and Vasopressor Use in Cirrhosis.
Semin Liver Dis
January 2025
Hepatology, University of Pennsylvania, Philadelphia, United States.
Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.
View Article and Find Full Text PDFPrediction of Cardiac Remodeling and/or Myocardial Fibrosis Based on Hemodynamic Parameters of Vena Cava in Athletes.
Curr Med Imaging
January 2025
Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Purpose: This study aimed to assess the hemodynamic changes in the vena cava and predict the likelihood of Cardiac Remodeling (CR) and Myocardial Fibrosis (MF) in athletes utilizing four-dimensional (4D) parameters.
Materials And Methods: A total of 108 athletes and 29 healthy sedentary controls were prospectively recruited and underwent Cardiac Magnetic Resonance (CMR) scanning. The 4D flow parameters, including both general and advanced parameters of four planes for the Superior Vena Cava (SVC) and Inferior Vena Cava (IVC) (sheets 1-4), were measured and compared between the different groups.
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!