Endovascular diagnosis and intervention in patients with isolated hyperammonemia, with or without ascites, after liver transplantation.
Hyperammonemia with or without ascites with normal synthetic liver functions after liver transplantation might indicate the presence of anastomotic stenosis of the portal or hepatic vein or the existence of a patent portosystemic shunt. The authors describe six patients, three children after split-liver transplantation and three adults after cadaver liver transplantation, who presented with hyperammonemia. Three patients had ascites. All lesions were successfully treated percutaneously; stents were placed in patients with anastomotic stenoses and coil embolization was performed in patients with patent portosystemic shunts--with either transhepatic or transjugular approaches according to the site of the abnormality. Ammonia levels returned to normal, and ascites had regressed completely for at least 3 months.
Belenky
Alexander
A
Department of Diagnostic Radiology, Unit of Vascular and Interventional Radiology, Rabin Medical Center, Keren Kayemet Leisrael 7, Petah Tiqwa 49372, Israel.
Igov
Igor
I
Konstantino
Youval
Y
Bachar
Gil N
GN
Mor
Eitan
E
Graif
Franklyn
F
Ben-Ari
Ziv
Z
Tur-Kaspa
Ran
R
Atar
Eli
E
D000293:Adolescent; D000328:Adult; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology* / Q000601:surgery*; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult