Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

07 October 2016 : Original article  

Resolution of Hepatic Venous Congestion Following Gradual Occlusion of Middle Hepatic Vein Interposition Graft in Living Donor Liver Transplantation

Varvara A. KirchnerABEF, Shin HwangABCDEFG, Gi-Won SongCG, Chul-Soo AhnD, Deok-Bog MoonD, Ki-Hun KimB, Dong-Hwan JungB, Tae-Yong HaB, Gil-Chun ParkB, Sung-Gyu LeeAD

DOI: 10.12659/AOT.900170

Ann Transplant 2016; 21:619-625


BACKGROUND: The middle hepatic vein (MHV) interposition vessel graft (IVG) is often occluded within a few months after living-donor liver transplantation (LDLT). We aimed to assess the mechanisms of resolving the hepatic venous congestion (HVC) that develops after gradual occlusion of the MHV-IVG.

MATERIAL AND METHODS: This study comprised two parts. Part I involved an assessment of the process of HVC resolution in the remnant right liver after donation of an extended left liver graft (n=100). Part II involved an evaluation of the timing and patterns of gradual MHV-IVG occlusion and HVC resolution in LDLT recipients (n=100).

RESULTS: In Part I, the analysis of 1-week dynamic computed tomography (CT) showed pre-existing collaterals in 8, appropriate compensation in 44, and HVC in 48 patients. In Part II, reconstruction of a segment V vein (V5) and a segment VIII vein (V8) was the most common reconstruction type (n=65). The patency rates of MHV-IVG were 90% at 3 months, 65% at 6 months, 37% at 12 months, and 18% at 24 months. The patency rate of V5 was inferior to that of V8. CT imaging analysis indicated that extrinsic compression of IVG, development of intrahepatic collaterals, and IVG shrinkage were the main mechanisms underlying late MHV-IVG occlusion. Moreover, the timing of MHV-IVG occlusion was well correlated with that of neo-collateralization.

CONCLUSIONS: MHV-IVG reconstruction effectively prevents HVC in LDLT. Although gradual MHV-IVG occlusion is well compensated by neo-collateralization, we believe that the patency of the IVG should be maintained for at least 6 months after LDLT.

Keywords: Hyperemia, Liver Transplantation, Living Donors, Vascular Grafting

Add Comment 0 Comments

859 10

In Press

06 Jun 2023 : Original article  

A 15-Year Retrospective Study of Supportive Extracorporeal Therapies Including Plasma Exchange and Continuo...

Ann Transplant In Press; DOI: 10.12659/AOT.939745  

02 Jun 2023 : Original article  

Survival analysis of transplant-associated thrombotic microangiopathy under different diagnostic criteria a...

Ann Transplant In Press; DOI: 10.12659/AOT.939890  

10 May 2023 : Original article  

Incidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...

Ann Transplant In Press; DOI: 10.12659/AOT.939143  

Most Viewed Current Articles

24 Aug 2021 : Review article  

Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives

DOI :10.12659/AOT.931664

Ann Transplant 2021; 26:e931664

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358