| Management of venous stenosis in living donor liver transplant recipients. | |
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MedLine Citation:
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PMID: 19842231 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To retrospectively evaluate the management and outcome of venous obstruction after living donor liver transplantation (LDLT). METHODS: From February 1999 to May 2009, 1 intraoperative hepatic vein (HV) tension induced HV obstruction and 5 postoperative HV anastomotic stenosis occurred in 6 adult male LDLT recipients. Postoperative portal vein (PV) anastomotic stenosis occurred in 1 pediatric left lobe LDLT. Patients ranged in age from 9 to 56 years (median, 44 years). An air balloon was used to correct the intraoperative HV tension. Emergent surgical reoperation, transjugular HV balloon dilatation with stent placement and transfemoral venous HV balloon dilatation was performed for HV stenosis on days 3, 15, 50, 55, and 270 after LDLT, respectively. Balloon dilatation followed with stent placement via superior mesenteric vein was performed for the pediatric PV stenosis 168 d after LDLT. RESULTS: The intraoperative HV tension was corrected with an air balloon. The recipient who underwent emergent reoperation for hepatic stenosis died of hemorrhagic shock and renal failure 2 d later. HV balloon dilatation via the transjugular and transfemoral venous approach was technically successful in all patients. The patient with early-onset HV stenosis receiving transjugular balloon dilatation and stent placement on the 15th postoperative day left hospital 1 wk later and disappeared, while the patient receiving the same interventional procedures on the 50th postoperative day died of graft failure and renal failure 2 wk later. Two patients with late-onset HV stenosis receiving balloon dilatation have survived for 8 and 4 mo without recurrent stenosis and ascites, respectively. Balloon dilatation and stent placement via the superior mesenteric venous approach was technically successful in the pediatric left lobe LDLT, and this patient has survived for 9 mo without recurrent PV stenosis and ascites. CONCLUSION: Intraoperative balloon placement, emergent reoperation, proper interventional balloon dilatation and stent placement can be effective as a way to manage hepatic and PV stenosis during and after LDLT. |
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Authors:
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Jie Yang; Ming-Qing Xu; Lu-Nan Yan; Wu-Sheng Lu; Xiao Li; Zheng-Rong Shi; Bo Li; Tian-Fu Wen; Wen-Tao Wang; Jia-Ying Yang |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of gastroenterology : WJG Volume: 15 ISSN: 1007-9327 ISO Abbreviation: World J. Gastroenterol. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-20 Completed Date: 2010-01-07 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 100883448 Medline TA: World J Gastroenterol Country: China |
Other Details:
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Languages: eng Pagination: 4969-73 Citation Subset: IM |
Affiliation:
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Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anastomosis, Surgical Balloon Dilatation* / instrumentation Child Constriction, Pathologic Graft Occlusion, Vascular / etiology, mortality, therapy* Graft Rejection / etiology, prevention & control Hepatic Veins / surgery* Humans Kidney Failure / etiology Liver Transplantation / adverse effects*, mortality Living Donors* Male Middle Aged Portal Vein / surgery* Reoperation Retrospective Studies Stents Time Factors Treatment Outcome Vascular Surgical Procedures / adverse effects*, mortality |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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