Early venous outflow obstruction after liver transplantation and treatment with cavo-cavostomy.
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.
Quintela
J
J
Department of General Surgery, Hospital Juan Canalejo, A Coruña, Spain. iquifan@yahoo.es
Fernández
C
C
Aguirrezabalaga
J
J
Gerardo
C
C
Marini
M
M
Suarez
F
F
Gomez
M
M
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