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Living donor liver transplantation for Budd–Chiari syndrome with hepatic inferior vena cava obstruction after open pericardial procedures

Surgery Today volume 43, pages 1180–1184 (2013)Cite this article

Abstract

Living donor liver transplantation (LDLT) for Budd–Chiari syndrome (BCS) presents a unique challenge as it does not involve replacement of the hepatic inferior vena cava (IVC). We report a case of successful LDLT in a patient with BCS associated with occlusion of the hepatic veins as well as the IVC. A 34-year-old woman with a history of two open pericardial procedures had decompensated liver failure and portal hypertension. Venography showed complete obstruction of the hepatic IVC and well-developed collateral vessels. We performed LDLT via sternotomy and laparotomy, with an end-to-end anastomosis between the left hepatic vein of the donor and the patient’s suprahepatic vena cava in the pericardium. The patient recovered uneventfully and has been doing well for 5 years. LDLT without caval replacement for BCS in a patient with hepatic IVC obstruction is feasible if the patient has good functional collaterals before liver transplantation.

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Abbreviations

BCS:

Budd–Chiari syndrome

LDLT:

Living donor liver transplantation

IVC:

Inferior vena cava

MELD:

Model for end-stage liver disease

PSVT:

Paroxysmal supraventricular tachycardia

PTFE:

Polytetrafluoroethylene

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Conflict of interest

Akinari Fukuda and his co-authors have no conflict of interest.

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Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Hospital, Kyoto, Japan

    Akinari Fukuda, Yasuhiro Ogura, Hiroyuki Kanazawa, Akira Mori, Michiya Kawaguchi, Yasutsugu Takada & Shinji Uemoto

  2. Division of Transplant Surgery, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan

    Akinari Fukuda

Authors
  1. Akinari Fukuda
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  2. Yasuhiro Ogura
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  3. Hiroyuki Kanazawa
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  4. Akira Mori
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  5. Michiya Kawaguchi
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  6. Yasutsugu Takada
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  7. Shinji Uemoto
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Correspondence to Akinari Fukuda.

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Fukuda, A., Ogura, Y., Kanazawa, H. et al. Living donor liver transplantation for Budd–Chiari syndrome with hepatic inferior vena cava obstruction after open pericardial procedures. Surg Today 43, 1180–1184 (2013). https://doi.org/10.1007/s00595-012-0440-1

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  • DOI: https://doi.org/10.1007/s00595-012-0440-1

Keywords

  • Living donor liver transplantation
  • Budd–Chiari syndrome
  • Inferior vena cava obstruction
  • Endvenectomy
  • Mesoatrial shunt