Korean J Transplant.  2022 Nov;36(Supple 1):S336. 10.4285/ATW2022.F-4803.

The treatment of hepatic vein anastomotic stenosis by uncovered metal stenting after liver transplantation

• Semedperlii M
• Batsaikhan T
• Samaindavga B
• Tsogtbaatar T
• Ganbold U
• Narangerel Y

• KMID: 2535563
• DOI: http://doi.org/10.4285/ATW2022.F-4803

Abstract

Background
The liver cirrhosis among with hepatocellular carcinoma is most common in Mongolia. The National Cancer Center of Mongolia started liver transplantation surgery in 2018 and successfully transplanted 59 cases till today. Although, some complications occurred and most of them were vascular complications. We are presenting the treatment of hepatic vein anastomotic stenosis by uncovered metal stenting after liver transplantation case which is our first case. Even tough, we had successfully treated the patient.
Methods
We placed in narrowed HV anastomoses by 1.4 cm×4.0 cm sized self-expandable metallic stent and 1.6 cm sized balloon catheter. Used materials including 8-Fr introducer, 0.035 guidewire, Cobra catheter and Omnipaque contrast agent.
Results
Fifty-eight-year-old female underwent living donor liver transplantation surgery due to dual viral related LC. Until postoperative day 23, she has ascites approximately 2 L, per day. On her Doppler sonography and computed tomography scan detected hepatic vein anastomoses stenosis. And, our multidisciplinary team discussed and decided to put stent treatment for the anastomoses. We successfully dilated the narrowed anastomoses by stenting.
Conclusions
Hepatic venous outflow defects including stenosis is one of the common vascular complication of liver transplantation. IR stenting procedure is more safe and quicker than surgery. Moreover, patient recovered instantly and clinical symptoms disappeared from the next day of the treatment. This case shows IR stenting treatment is the first choice for vascular complications.