title: Long-term outcome of percutaneous interventions for hepatic venous outflow obstruction after pediatric living donor liver transplantation: experience from a single institute.
abstract: OBJECTIVE
  To evaluate retrospectively the long-term outcome of percutaneous interventions for hepatic venous outflow obstruction (HVOO) occurring after pediatric living donor liver transplantation (LDLT).
  
  
  METHODS
  Between October 1997 and December 2012, 48 patients (24 boys, 24 girls; median age, 6 y) who had undergone LDLT were confirmed to have HVOO using percutaneous hepatic venography and manometry. All patients underwent percutaneous interventions, including balloon angioplasty with or without stent placement. Technical success, clinical success, patency rates, stent placement, and major complications were evaluated.
  
  
  RESULTS
  Technical success was achieved in 92 of 93 sessions (99.0%) and in 47 of 48 patients (97.9%), and clinical success was achieved in 41 of 48 patients (85.4%). During the follow-up period (range, 1-182 mo; median, 51.5 mo), 28 patients were treated with a single session of balloon angioplasty, and 20 patients who developed recurrent stenosis were treated with repeated percutaneous interventions. The rates of primary and primary-assisted patency at 1, 3, 5, and 10 years after balloon angioplasty were 64%, 57%, 57%, and 52% (primary patency) and 98%, 95%, 95%, and 95% (primary-assisted patency). Of six patients with stent placement, four had no recurrent HVOO after the stent placement, but two developed recurrent stenosis. The stent migrated to the right atrium in one patient.
  
  
  CONCLUSIONS
  Percutaneous interventions were effective treatments for HVOO after LDLT.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine,54-Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yabuta
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shibata
authors.forename: Toyomichi
authors.initials: T
authors.lastname: Shibata
authors.forename: Ken
authors.initials: K
authors.lastname: Shinozuka
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Isoda
authors.forename: Shinya
authors.initials: S
authors.lastname: Okamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Kaori
authors.initials: K
authors.lastname: Togashi
mesh_terms: D000367:Age Factors; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007564:Japan; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008365:Manometry; D010690:Phlebography; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: HVOO; LDLT; hepatic venous outflow obstruction; living donor liver transplantation