Percutaneous transluminal venoplasty after venous pressure measurement in patients with hepatic venous outflow obstruction after living donor liver transplantation.

Abstract

PURPOSE:

The aim of this study was to evaluate retrospectively the outcome of percutaneous transluminal venoplasty (PTV) after venous pressure measurement in patients with hepatic venous outflow obstruction following living donor liver transplantation (LDLT).

MATERIALS AND METHODS:

We studied 24 consecutive patients suspected of having hepatic venous outflow obstruction after LDLT. Pressure gradients were measured proximal and distal to the lesion, and gradient values >3 mmHg were considered hemodynamically significant. We evaluated the technical success, complications, outcome of venoplasty and recurrence, and the patency rate.

RESULTS:

In all, 11 female patients manifested a pressure gradient >3 mmHg across the anastomotic site; they underwent subsequent PVT. The initial balloon venoplasty procedure was technically successful in 10 of the 11 patients (91%), and the pressure gradient was reduced from 5.8 to 1.1 mmHg (P < 0.01). Clinical improvement was observed in 9 of these 10 patients; one patient failed to improve and underwent retransplantation. Recurrent obstruction occurred in four patients; they underwent PTV with (n = 2) or without (n = 2) stent placement. There were no major procedural complications.

CONCLUSION:

PTV following venous pressure measurement is an effective and safe treatment for venous outflow obstruction in patients subjected to LDLT. In patients with recurrent obstruction, re-venoplasty is recommended.

• Authors: Osamu Ikeda, Yoshitaka Tamura, Yutaka Nakasone, Yasuyuki Yamashita, Hideaki Okajima, Katsuhiro Asonuma, Yukihiro Inomata
• Journal: Japanese journal of radiology (Jpn J Radiol) Vol. 28 Issue 7 Pg. 520-6 (Aug 2010) ISSN: 1867-108X [Electronic] Japan
• PMID: 20799017 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Angiography
• Budd-Chiari Syndrome (diagnostic imaging, etiology, therapy)
• Catheterization (methods)
• Child
• Child, Preschool
• Female
• Fluoroscopy
• Humans
• Infant
• Liver Transplantation (methods)
• Living Donors
• Middle Aged
• Recurrence
• Retrospective Studies
• Treatment Outcome
• Vascular Patency
• Venous Pressure