Long-term follow-up after endovascular treatment of hepatic venous outflow obstruction following liver transplantation.

Autor: Pitchaimuthu M; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Roll GR; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.; Division of Transplant Surgery, University of California, San Francisco, CA, USA., Zia Z; Department of Radiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Olliff S; Department of Radiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Mehrzad H; Department of Radiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Hodson J; National Institute for Health Research Birmingham, Liver Biomedical Research Unit and Centre for Liver Research, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Gunson BK; National Institute for Health Research Birmingham, Liver Biomedical Research Unit and Centre for Liver Research, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Perera MT; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Isaac JR; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Muiesan P; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Mirza DF; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.; National Institute for Health Research Birmingham, Liver Biomedical Research Unit and Centre for Liver Research, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Mergental H; Liver Unit Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. hynek.mergental@uhb.nhs.uk.; National Institute for Health Research Birmingham, Liver Biomedical Research Unit and Centre for Liver Research, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. hynek.mergental@uhb.nhs.uk.
Jazyk: angličtina
Zdroj: Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 2016 Oct; Vol. 29 (10), pp. 1106-16. Date of Electronic Publication: 2016 Sep 13.
DOI: 10.1111/tri.12817
Abstrakt: Hepatic venous outflow obstruction (HVOO) is a rare complication after liver transplantation (LT) associated with significant morbidity and reduced graft survival. Endovascular intervention has become the first-line treatment for HVOO, but data on long-term outcomes are lacking. We have analysed outcomes after endovascular intervention for HVOO in 905 consecutive patients who received 965 full-size LT at our unit from January 2007 to June 2014. There were 27 (3%) patients who underwent hepatic venogram for suspected HVOO, with persistent ascites being the most common symptom triggering the investigation (n = 19, 70%). Of those, only 10 patients demonstrated either stricture or pressure gradient over 10 mmHg on venogram, which represents a 1% incidence of HVOO. The endovascular interventions were balloon dilatation (n = 3), hepatic vein stenting (n = 4) and stenting with dilatation (n = 3). Two patients required restenting due to stent migration. The symptoms of HVOO completely resolved in all but one patient, with a median follow-up period of 74 (interquartile range 39-89) months. There were no procedure-related complications or mortality. In conclusion, the incidence of HVOO in patients receiving full-size LT is currently very low. Endovascular intervention is an effective and safe procedure providing symptom relief with long-lasting primary patency.
(© 2016 Steunstichting ESOT.)
Databáze: MEDLINE
Externí odkaz: