Interventional radiology in liver transplantation

Amesur, Nikhil B.; Zajko, Albert B.

doi:10.1002/lt.20731

Cited by 46 publications

(24 citation statements)

References 196 publications

(195 reference statements)

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“…14 Angioplasty may not be effective due to elastic recoil. 15 Multiple dilations may be needed to ensure long-term patency. Stent placement is indicated for residual or recurrent stenosis but sometimes as primary treatment.…”

Section: Portal Vein Stenosismentioning

confidence: 99%

“…Stent placement is indicated for residual or recurrent stenosis but sometimes as primary treatment. 15,16 Figure 3 shows a 56-year-old liver transplant recipient who presented with recurrent ascites due to high-grade stricture at the level of the proximal inferior vena cava accompanied by anastomosis, exending to the hepatic veins. The patient received a venous angioplasty, resulting in significant angiographic and clinical improvement, although her pressure gradient was not significantly changed.…”

Section: Portal Vein Stenosismentioning

confidence: 99%

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Untitled

2015

Exp Clin Transplant

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Objectives: Recipients of liver transplant are surviving longer as both the surgical procedure and postsurgical care have improved. Despite improvements, serious complications from the procedure remain that significantly affect patient outcome and may result in retransplant. Refractory ascites is one complication, occurring in about 5.6% of transplant recipients. Management of refractory ascites after liver transplant presents a challenge to the multidisciplinary team caring for these patients. Materials and Methods:We discuss approaches to the diagnosis and treatment of refractory ascites after liver transplant, based on a literature review, with a primary focus on vascular causes. These approaches are illustrated by case examples highlighting our experiences at an academic tertiary medical center. We propose a clinical practice algorithm for optimal endovascular treatment of refractory ascites after liver transplant. Results: The cornerstone of refractory ascites care is diagnosis and treatment of the cause. Vascular causes are not infrequently encountered and, if not treated early, are associated with graft loss and high morbidity and mortality and are major indications for retransplant. For patients with recurrent disease or graft rejection needing large volume paracentesis, the use of a transjugular intrahepatic portosystemic shunt may serve as a bridge to more definitive treatment (retransplant), although it may not be as effective for managing ascites as splenic artery embolization, arguably underused, which is emerging as a potential alternative treatment option. Conclusions: A multidisciplinary strategy for the diagnosis and care of patients with refractory ascites after liver transplant is crucial, with endovascular treatment playing an important role. The aim is for this document to serve as a concise and informative reference to be used by those who may care for patients with this rare yet serious diagnosis.

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Section: Portal Vein Stenosismentioning

confidence: 99%

Section: Portal Vein Stenosismentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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“…Balloon dilatation is performed with large-sized catheters. Due to the large size of the IVC, simultaneous inflation of multiple balloons has been described [1] . In our practice, during the procedure, radial or femoral arter y pressure measurement is performed to continuously monitor changes in systemic hemodynamics during balloon dilatation, and consequent …”

Section: Ivc Stenosis (Ivcs)mentioning

confidence: 99%

“…Advances in the field of percutaneous, radiological, minimally invasive techniques have increased the importance of interventional radiology in the management of patients after LT [1] . In this article, we discuss the possible applications of interventional radiology in the management of adult recipients after deceased donor LT or living related LT (LRLT), including diagnosis of graft disease, treatment of vascular complications and treatment of biliary complications.…”

Section: Introductionmentioning

confidence: 99%

Interventional radiology procedures in adult patients who underwent liver transplantation

Miraglia

Maruzzelli

Caruso

et al. 2009

WJG

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Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT.

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“…In 18% of cases, only the vena cava caudalis was affected, while the hepatic veins were affected in 10% of the cases. The blockages in the vena cava caudalis can be severe and may cause hepatocellular necrosis, hepatic failure, cirrhosis, and encephalopathy (4,5). BCS is very rare in the literature and practice in domestic animals.…”

Section: Introductionmentioning

confidence: 99%

The Effects of L-Carnitine in Budd-Chiari Syndrome in a Domestic Cat

Öztürk¹,

Altuğ²,

Köse³

et al. 2016

Macedonian Veterinary Review

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Case Report Mac Vet Rev 2016; 39 (1): 123-127 This paper describes a thrombosis in the vena cava caudalis of a 15 year-old cat with ascites. Trauma and eventually feline enteric corona virus infection in the cat were not detected. In the intrahepatic region, a blockage of vena cava caudalis was brought to light by ultrasonographic imaging. An aspirate of abdominal fl uid revealed modified transudate. Liver enzyme levels were increased in the serum sample of the cat. The levels of total oxidant status (TOS) and total antioxidant status (TAS) were elevated in the peritoneal fluid. Liver protection diet with L-carnitine, diuretic therapy and antimicrobial drugs were administrated for treatment of the cat. During the continuous treatment, the amount of abdominal fluid decreased, but never completely absorbed. L-carnitine was administered to the cat during the time of treatment, and subsequently the levels of liver enzymes decreased. However, the cat died because of recurrent ascites and persistent thrombosis. In conclusion, ultrasonographic examination was very reliable, non-invasive and highly useful diagnostic method for BCS and L-carnitine has crucial effects on the quality of life, energy metabolism and liver enzyme levels. However, the blockage of the vena cava caudalis could not completely respond to medical treatment and thrombosis should be eliminated by surgical intervention.

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Interventional radiology in liver transplantation

Cited by 46 publications

References 196 publications

Untitled

Untitled

Interventional radiology procedures in adult patients who underwent liver transplantation

The Effects of L-Carnitine in Budd-Chiari Syndrome in a Domestic Cat

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