title: Balloon-occluded retrograde transvenous obliteration is feasible for prolonged portosystemic shunts after living donor liver transplantation.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the efficacy of balloon-occluded retrograde transvenous obliteration (B-RTO) in patients after living donor liver transplantation (LDLT).
  
  
  METHODS
  Five patients with gastric varices (GVx) and/or liver dysfunction who were treated with B-RTO from January 2001 to December 2007 were enrolled in this study (GVx, n = 2; liver dysfunction, n = 1; both, n = 2). The eradication rate of the GVx, portal vein hemodynamics and improvement of liver function were evaluated.
  
  
  RESULTS
  B-RTO was performed successfully, and the GVx disappeared or decreased markedly in all patients. Recurrence of GVx was not observed during the follow-up. Significantly increased portal vein inflow and improved liver function were observed in all patients.
  
  
  CONCLUSIONS
  B-RTO may be an effective treatment for patients after LDLT to prevent bleeding from GVx or to modulate portal vein inflow that is reduced by prolonged large portosystemic shunts.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, yoshihiro@nagao.ws.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nagao
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Akahoshi
authors.forename: Hideo
authors.initials: H
authors.lastname: Uehara
authors.forename: Naotaka
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Nao
authors.initials: N
authors.lastname: Kinjo
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawanaka
authors.forename: Morimasa
authors.initials: M
authors.lastname: Tomikawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Uchiyama
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Yuuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000628:therapy*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012039:Regional Blood Flow