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KMID : 0371420180950060333
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Annals of Surgical Treatment and Research
2018 Volume.95 No. 6 p.333 ~ p.339
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Long-term outcomes after stent insertion in patients with early and late hepatic vein outflow obstruction after living donor liver transplantation
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Kim Kyeong-Sik
Lee Ji-Soo
Choi Gyu-Sung
Kwon Choon-Hyuck David
Cho Jae-Won
Lee Suk-Koo
Park Kwang-Bo
Cho Sung-Ki
Shin Sung-Wook
Kim Jong-Man
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Abstract
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Purpose: The purpose of this study was to describe the long-term effects of stenting in patients with hepatic venous outflow obstruction (HVOO), who underwent living donor liver transplantation (LDLT).
Methods: Between January 2000 and December 2009, 622 adult patients underwent LDLT at our hospital, and of these patients, 21 (3.3%) were diagnosed with HVOO; among these patients, 17 underwent stenting. The patients were divided into early or late groups according to the time of their HVOO diagnoses (cutoff: 60 days after liver transplantation).
Results: The median follow-up period was 54.2 months (range, 0.5?192.4 months). Stent insertion was successful in 8 of 10 patients in the early group and 6 of 7 in the late group. The 5-year primary patency rates were 46% and 20%, respectively. In both groups, patients with recurrent HVOO at the beginning showed kinking confirmed by venography. Patients who carried their stents for more than 3 years maintained long-term patency. There was no significant difference in spleen size between groups; however, when the groups were compared according to whether they maintained patency, spleens tended to be smaller in the patency-maintained group.
Conclusion: Unlike stenosis, if kinking is confirmed on venography, stenting is not feasible in the long term for patients with LDLT.
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KEYWORD
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Liver transplantation, Hepatic veins, Complications, Stents
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