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Early venous outflow obstruction after liver transplantation and treatment with cavo-cavostomy.

AbstractOBJECTIVE:
The objective of this study was to describe by a retrospective analysis the evolution of patients who needed an end-to side cavo-cavostomy in addition to a previous cavo-caval anastomosis, during orthotopic liver transplantation (OLT), caused by hepatic venous outflow obstruction.
METHODS:
We reviewed 673 consecutive OLT and the treatment and evolution of technique-related complications.
RESULTS:
This study of 673 consecutive OLT, all with the piggyback modality included 23 cases (22 patients and 23 grafts) who underwent an additional cavo-caval anastomosis for venous outflow problems either perioperatively or during the immediate postoperative period. One patient developed an early and 3 developed a late, caval stenosis that was successfully treated using angioplasty. Five patients died postoperatively. Causes of death were sepsis (n = 3), thrombosis of a mesenteric bypass (n = 1), and massive hemorrhage (n = 1). Long time evolution was as follows: 2 patients died at 7 and 45 months, respectively, (viral relapse) and the other 15 subjects are alive and well.
AuthorsJ Quintela, C Fernández, J Aguirrezabalaga, C Gerardo, M Marini, F Suarez, M Gomez
JournalTransplantation proceedings (Transplant Proc) 2009 Jul-Aug Vol. 41 Issue 6 Pg. 2450-2 ISSN: 1873-2623 [Electronic] United States
PMID19715948 (Publication Type: Journal Article)
Topics
  • Anastomosis, Surgical (adverse effects, methods, mortality)
  • Budd-Chiari Syndrome (etiology, surgery)
  • Constriction, Pathologic (etiology, surgery)
  • Graft Survival
  • Humans
  • Liver Transplantation (adverse effects, methods)
  • Postoperative Complications (epidemiology, surgery)
  • Retrospective Studies
  • Survival Rate

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