title: Portal venous perfusion steal causing graft dysfunction after orthotopic liver transplantation: serial imaging findings in a successfully treated patient.
abstract: A 53-year-old male with hepatocellular carcinoma underwent orthotopic liver transplantation. Preoperative computed tomography revealed main portal vein luminal narrowing by flat thrombi and the development of cavernous transformation. On post-transplantation day 1, thrombotic portal venous occlusion occurred, and emergency thrombectomy was performed. Subsequent Doppler ultrasonography and contrast-enhanced ultrasonography confirmed the restoration of normal portal venous flow. The next day, however, decreased portal venous velocity was observed via Doppler ultrasonography, and serum liver enzymes and bilirubin levels remained persistently elevated. Direct portography identified massive perfusion steal through prominent splenorenal collateral veins. Stent insertion and balloon angioplasty of the portal vein were performed, and subsequent Doppler ultrasonography demonstrated normalized portal flow parameters. Afterwards, the serum liver enzymes and bilirubin levels rapidly normalized.
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Minsu
authors.identifier: 0000-0003-1943-3677
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Kyum
authors.identifier: 0000-0003-0768-9923
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Eun
authors.identifier: 0000-0003-0811-9578
authors.initials: YE
authors.lastname: Chung
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin-Young
authors.identifier: 0000-0002-9025-6274
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Mi-Suk
authors.identifier: 0000-0001-5817-2444
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joon Seok
authors.identifier: 0000-0002-0334-5042
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Myeong-Jin
authors.identifier: 0000-0001-7949-5402
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea ; Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Honsoul
authors.identifier: 0000-0002-2367-234X
authors.initials: H
authors.lastname: Kim
keywords: Liver transplantation; Perfusion; Portosystemic shunt, surgical; Ultrasonography, Doppler
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