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Isolated right hepatic vein obstruction after piggyback liver transplantation

✍ Scribed by Federico Aucejo; Charles Winans; J. Michael Henderson; David Vogt; Bijan Eghtesad; John J. Fung; Mark Sands; Charles M. Miller

Publisher
John Wiley and Sons
Year
2006
Tongue
English
Weight
207 KB
Volume
12
Category
Article
ISSN
1527-6465

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✦ Synopsis

The "piggyback" technique for liver transplantation has gained worldwide acceptance. Still, complications such as outflow obstruction have been observed, usually attributable to technical errors such as small-caliber anastomosis of the suprahepatic vena cava, twisting, or kinking. Iatrogenic Budd-Chiari syndrome after piggyback liver transplantation has been reported as a consequence of obstruction involving the entire anastomosis (usually the 3 hepatic veins). Here we describe technical issues, clinical presentation, diagnosis, and treatment of 3 cases in which outflow obstruction affected only the right hepatic vein. In conclusion, all 3 patients developed recurrent ascites requiring angioplasty and/or stent placement across the right hepatic vein to alleviate the symptoms.

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