Successful stent placement for hepatic venous outflow obstruction in pediatric living donor liver transplantation, including a case series review |
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Authors: | Sakamoto Seisuke Ogura Yasuhiro Shibata Toshiya Haga Hironori Ogawa Kohei Oike Fumitaka Ueda Mikiko Egawa Hiroto Takada Yasutsugu Uemoto Shinji |
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Affiliation: | Department of Surgery, Faculty of Medicine,;and Department of Radiology, Faculty of Medicine;, Laboratory of Anatomic Pathology, Faculty of Medicine, Kyoto University, Kyoto, Japan |
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Abstract: | Abstract: HVOO may lead to graft dysfunction in LDLT. Balloon angioplasty is the first treatment for HVOO. However, some cases with recurrent HVOO need multiple interventions and require stent placement. The authors describe a pediatric case with recurrent HVOO requiring multiple stent placements. Her symptoms related to HVOO finally disappeared after the third stenting. A year later, follow-up liver biopsy did not show any dramatic change in perivenular fibrosis. From a review of our pediatric cases with HVOO requiring stent placement, the majority of them lost the grafts, because the timing of stent placement was too late to prevent the progression of fibrosis. In conclusion, stent placement should be considered in select cases of HVOO. Serial liver biopsies evaluating the degree of fibrosis are essential in determining the timing of stent placement. |
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Keywords: | hepatic venous outflow obstruction living donor liver transplantation balloon angioplasty/stent |
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