title: Successful transjugular balloon dilatation of the hepatic vein stenosis causing hypoalbuminemia after pediatric living-donor liver transplantation.
abstract: 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.
authors.affiliation: 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
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yokomuro
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Takahashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: 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
chemical_list: D006820:Hyaluronic Acid