Annals of Surgical Treatment and Research

The Korean Surgical Society (대한외과학회)
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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

  • Kim, Kyeong Sik (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Ji Soo (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Gyu Sung (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, Choon Hyuck David (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Jae-Won (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Suk-Koo (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Kwang Bo (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Sung Ki (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Sung Wook (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Jong Man (Department of Surgery-Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2018.02.14
  • Accepted : 2018.06.29
  • Published : 2018.12.01
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Abstract

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.

Keywords

References

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