title: Isolated right hepatic vein obstruction after piggyback liver transplantation.
abstract: The "piggyback" technique for liver transplantation has gained worldwide acceptance. Still, complications such as outflow obstruction have been observed, usually attributable to technical errors such as small-caliber anastomosis of the suprahepatic vena cava, twisting, or kinking. Iatrogenic Budd-Chiari syndrome after piggyback liver transplantation has been reported as a consequence of obstruction involving the entire anastomosis (usually the 3 hepatic veins). Here we describe technical issues, clinical presentation, diagnosis, and treatment of 3 cases in which outflow obstruction affected only the right hepatic vein. In conclusion, all 3 patients developed recurrent ascites requiring angioplasty and/or stent placement across the right hepatic vein to alleviate the symptoms.
authors.affiliation: Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: Federico
authors.initials: F
authors.lastname: Aucejo
authors.forename: Charles
authors.initials: C
authors.lastname: Winans
authors.forename: J Michael
authors.initials: JM
authors.lastname: Henderson
authors.forename: David
authors.initials: D
authors.lastname: Vogt
authors.forename: Bijan
authors.initials: B
authors.lastname: Eghtesad
authors.forename: John J
authors.initials: JJ
authors.lastname: Fung
authors.forename: Mark
authors.initials: M
authors.lastname: Sands
authors.forename: Charles M
authors.initials: CM
authors.lastname: Miller
mesh_terms: D006502:Budd-Chiari Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged