title: Successful stent placement for hepatic venous outflow obstruction in pediatric living donor liver transplantation, including a case series review.
abstract: HVOO may lead to graft dysfunction in LDLT. Balloon angioplasty is the first treatment for HVOO. However, some cases with recurrent HVOO need multiple interventions and require stent placement. The authors describe a pediatric case with recurrent HVOO requiring multiple stent placements. Her symptoms related to HVOO finally disappeared after the third stenting. A year later, follow-up liver biopsy did not show any dramatic change in perivenular fibrosis. From a review of our pediatric cases with HVOO requiring stent placement, the majority of them lost the grafts, because the timing of stent placement was too late to prevent the progression of fibrosis. In conclusion, stent placement should be considered in select cases of HVOO. Serial liver biopsies evaluating the degree of fibrosis are essential in determining the timing of stent placement.
authors.affiliation: Department of Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan. sseisuke@kuhp.kyoto-u.ac.jp
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogura
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shibata
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
authors.forename: Kohei
authors.initials: K
authors.lastname: Ogawa
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Oike
authors.forename: Mikiko
authors.initials: M
authors.lastname: Ueda
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Takada
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D006502:Budd-Chiari Syndrome / Q000209:etiology / Q000628:therapy*; D005260:Female; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D019919:Prosthesis Implantation; D012008:Recurrence; D012086:Reoperation; D015607:Stents