Percutaneous transhepatic stenting in management of post living donor liver transplantation hepatic venous stenosis

Abstract

Aim: To evaluate the effectiveness and safety of percutaneous transhepatic stent placement in management of hepatic venous outflow obstruction after living-donor liver transplantation (LDLT). Materials and methods: From September 2010 to May 2015 percutaneous transhepatic venography was performed in 30 patients of 489 patients who underwent LDLT with suspected hepatic venous outflow obstruction with stent placement performed in 25 patients. Patient follow-up included clinical and laboratory data collection, Doppler ultrasonography (US), hepatic venography, and computed tomography. Technical success, complications, clinical improvement, and recurrence were evaluated. Results: Technical success was achieved in all patients. The mean pressure gradients across the stenosis before and after the procedure were 17.8 mmHg ± 6.4 (range, 3–39 mmHg) and 2.4 mmHg ± 2.6 (range, 0–8 mmHg), respectively. Four patients developed recurrent stenosis, and these patients underwent balloon angioplasty and remained with no events until the end of the observation period. During the mean follow-up period of 21 months (range 10–40 months) clinical success was achieved in 24 of 25 patients (96%). Conclusion: In conclusion, percutaneous transhepatic stenting is safe and effective for venous outflow obstruction after LDLT.

Keywords

• Post LDLT venous stenosis
• Transhepatic stenting
• Outflow obstruction
• Percutaneous stenting