Long-term outcomes after stent insertion in patients with early and late hepatic vein outflow obstruction after living donor liver transplantation.
10.4174/astr.2018.95.6.333
- Author:
Kyeong Sik KIM
1
;
Ji Soo LEE
;
Gyu Sung CHOI
;
Choon Hyuck David KWON
;
Jae Won CHO
;
Suk Koo LEE
;
Kwang Bo PARK
;
Sung Ki CHO
;
Sung Wook SHIN
;
Jong Man KIM
Author Information
1. Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jongman94.kim@samsung.com
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Hepatic veins;
Complications;
Stents
- MeSH:
Adult;
Budd-Chiari Syndrome;
Constriction, Pathologic;
Diagnosis;
Follow-Up Studies;
Hepatic Veins*;
Humans;
Liver Transplantation*;
Liver*;
Living Donors*;
Phlebography;
Spleen;
Stents*
- From:Annals of Surgical Treatment and Research
2018;95(6):333-339
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT). METHODS: Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation). RESULTS: The median follow-up period was 54.2 months (range, 0.5–192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group. CONCLUSION: Unlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.
