Successful transjugular balloon dilatation of the hepatic vein stenosis causing hypoalbuminemia after pediatric living-donor liver transplantation.
Hepatic vein (HV) stenosis after liver transplantation is a rare but life-threatening complication that leads to graft loss. The incidence of HV stenosis after living-donor liver transplantation (LDLT) and split liver transplantation is not so rare, and is reported to range from 2 to 8.6%. Recently, the minimal invasiveness of radiologic interventions and the innovative techniques have led to their widespread adoption for the treatment of various complications after liver transplantation. We report a five-year-old boy with HV stenosis post-LDLT with only scarcity of clinical information including edema with hypoalbuminemia and elevated hyaluronic acid value. Doppler ultrasonography was effective to suggest stenosis, and angiography confirmed its diagnosis. The stenosis was successfully treated with balloon dilatation using interventional radiologic technique through the jugular vein. In conclusion, we suggest that if liver transplanted patients manifest ascites or/and edema with hypoalbuminemia and elevated hyaluronic acid in sera, HV stenosis should be suspected even if the other laboratory values are normal.
Kawano
Youichi
Y
Department of Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine, Tokyo, 1-1-5 Sendagi, Bunkyou-ku, Tokyo 113-8603, Japan. surg.1@d8.dion.ne.jp
Akimaru
Koho
K
Taniai
Nobuhiko
N
Yoshida
Hiroshi
H
Yokomuro
Shigeki
S
Mamada
Yasuhiro
Y
Mizuguchi
Yoshiaki
Y
Shimizu
Tetsuya
T
Takahashi
Tsubasa
T
Tajiri
Takashi
T
D002404:Catheterization / Q000379:methods*; D002648:Child; D003251:Constriction, Pathologic; D006503:Hepatic Veins / Q000473:pathology*; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism; D034141:Hypoalbuminemia / Q000209:etiology* / Q000628:therapy; D008099:Liver / Q000000981:diagnostic imaging*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods
D006820:Hyaluronic Acid