title: Early venous outflow obstruction after liver transplantation and treatment with cavo-cavostomy.
abstract: OBJECTIVE
  The objective of this study was to describe by a retrospective analysis the evolution of patients who needed an end-to side cavo-cavostomy in addition to a previous cavo-caval anastomosis, during orthotopic liver transplantation (OLT), caused by hepatic venous outflow obstruction.
  
  
  METHODS
  We reviewed 673 consecutive OLT and the treatment and evolution of technique-related complications.
  
  
  RESULTS
  This study of 673 consecutive OLT, all with the piggyback modality included 23 cases (22 patients and 23 grafts) who underwent an additional cavo-caval anastomosis for venous outflow problems either perioperatively or during the immediate postoperative period. One patient developed an early and 3 developed a late, caval stenosis that was successfully treated using angioplasty. Five patients died postoperatively. Causes of death were sepsis (n = 3), thrombosis of a mesenteric bypass (n = 1), and massive hemorrhage (n = 1). Long time evolution was as follows: 2 patients died at 7 and 45 months, respectively, (viral relapse) and the other 15 subjects are alive and well.
authors.affiliation: Department of General Surgery, Hospital Juan Canalejo, A Coruña, Spain. iquifan@yahoo.es
authors.forename: J
authors.initials: J
authors.lastname: Quintela
authors.forename: C
authors.initials: C
authors.lastname: Fernández
authors.forename: J
authors.initials: J
authors.lastname: Aguirrezabalaga
authors.forename: C
authors.initials: C
authors.lastname: Gerardo
authors.forename: M
authors.initials: M
authors.lastname: Marini
authors.forename: F
authors.initials: F
authors.lastname: Suarez
authors.forename: M
authors.initials: M
authors.lastname: Gomez
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006502:Budd-Chiari Syndrome / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate