Left lobe graft poses a potential risk of hepatic venous outflow obstruction in adult living donor liver transplantation

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Toshihiro KitajimaS Uemoto

Abstract

Hepatic venous outflow obstruction (HVOO) is a critical complication after living donor liver transplantation (LDLT). This study aimed to evaluate the incidence of HVOO and the risk factors for HVOO in adults. From 2005 to 2015, 430 adult LDLT patients (right lobe [RL] graft, 270 patients; left lobe [LL] graft, 160 patients) were enrolled and divided into no HVOO (n = 413) and HVOO (n = 17) groups. Patient demographics and surgical data were compared, and risk factors for HVOO were analyzed. Furthermore, the longterm outcomes of percutaneous interventions as treatment for HVOO were assessed. HVOO occurred in 17 (4.0%) patients. The incidence of HVOO in patients receiving a LL graft was significantly higher than in those receiving a RL graft (8.1% versus 1.5%; P = 0.001). The body weight and caliber of hepatic vein anastomosis in the HVOO group were significantly lower compared with the no HVOO group (P = 0.02 and P = 0.008, respectively). Multivariate analysis revealed that only LL graft was an independent risk factor for HVOO (OR, 4.782; 95% CI, 1.387-16.488; P = 0.01). Among 17 patients with HVOO, 7 patients were treated with single balloon angioplasty, and 9 patients who developed recurrence were treated with repeated interv...Continue Reading

References

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Citations

Feb 16, 2017·Nature Reviews. Gastroenterology & Hepatology·Robert A Fisher
Jan 26, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Toshihiro KitajimaShunji Nagai
Aug 28, 2018·Journal of Vascular Surgery Cases and Innovative Techniques·Kuo-Shyang JengKuo-Hsin Chen
Dec 6, 2017·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Suleyman KocSezai Yilmaz

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