Budd-Chiari syndrome and liver transplantation

Akamatsu, Nobuhisa; Sugawara, Yasuhiko; Kokudo, Norihiro

doi:10.5582/irdr.2014.01031

Cited by 47 publications

(57 citation statements)

References 90 publications

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“…or secondary (associated with hepatocellular carcinoma, non-parasitic cyst, echinococcal disease, epithelioid hemangioendothelioma, etc.). [ 1 2 ] The BCS cases for which the examinations provided no indication of the underlying pathology were categorized as idiopathic. For our study, the BCS cases were grouped according to acute and chronic BCS status, according to the timing of appearance of the various characteristic clinical signs and symptoms.…”

Section: Methodsmentioning

confidence: 99%

“…The indications for LT in the BCS patient population include fulminant hepatic failure, cirrhosis, and failure of a previous treatment attempt with portosystemic shunting or nonsurgical therapeutic modalities. [ 1 3 ] Most of the available literature on LT for BCS reports data on deceased donor liver transplantation (DDLT), and only a few reports have addressed applications and outcomes of living donor liver transplantation (LDLT) [2] …”

Section: Introductionmentioning

confidence: 99%

“…In BCS patients undergoing LDLT, hepatic venous reconstruction can be more difficult than in the DDLT procedure, particularly in construction of adequate anastomoses [2] . In DDLT the recipient's VCI is generally replaced by the donor's, since the liver graft contains the retrohepatic VCI.…”

Section: Introductionmentioning

confidence: 99%

“…In DDLT the recipient's VCI is generally replaced by the donor's, since the liver graft contains the retrohepatic VCI. [ 2 3 ] In contrast, in LDLT the recipient's VCI is preserved, most frequently via the piggy-back technique. In the absence of a donor retrohepatic VCI, the anastomosis between the recipient's hepatic vein cuff and the graft's hepatic vein is created using a partial liver graft.…”

Section: Introductionmentioning

confidence: 99%

“…In the absence of a donor retrohepatic VCI, the anastomosis between the recipient's hepatic vein cuff and the graft's hepatic vein is created using a partial liver graft. [ 2 3 ] Specific venous drainage models are required which correspond to the level and size of the stenotic or the obliterated retrohepatic VCI. [ 2 3 ] …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Living donor liver transplantation for Budd–Chiari syndrome

Ara

Akbulut²,

Ince³

et al. 2016

Medicine

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Background:The aim of the study was to report the detailed surgical techniques of living donor liver transplantation (LDLT) in patients with Budd–Chiari syndrome (BCS).Methods:Demographic and surgical techniques characteristics of 39 patients with BCS who underwent LDLT were retrospectively reviewed. Thirty-two of them had native vena cava inferior (VCI) preservation and 6 had retrohepatic VCI resection with venous continuity established by cryopreserved VCI (n = 4) or aortic graft (n = 2). In 1 patient, the anastomosis was established between the graft hepatic vein (HV) and the suprahepatic VCI. For preservation of the native VCI, immediately before the graft implantation, the thickened anterior, and right/left lateral walls of the recipient VCI were resected caudally and cranially until the intact vein wall was reached, and then an anastomosis was created between the (HV) of the graft reconstructed as a circumferential fence and the reconstructed recipient VCI. For resection of the retrohepatic VCI, the anastomosis was created with the same technique in all 6 patients in whom VCI was reformed by using a vascular graft.Results:Post-LT complications developed in 19 of the patients. Complications related to the biliary anastomosis accounted for 12 of these cases, with 11 treated by PTC and/or ERCP, and 1 by hepaticojejunostomy. Two of the 39 patients developed recurrent BCS and were treated by interventional radiological methods. Thirteen patients died and none were related to the BCS recurrence.Conclusion:Favorable outcomes are achievable with LDLT treatment of patients with BCS, which carries important implications for countries with inadequate cadaveric donor pools.

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Section: Methodsmentioning

confidence: 99%