title: Effective balloon-occluded retrograde transvenous obliteration of the superior mesenteric vein-inferior vena cava shunt in a patient with hepatic encephalopathy after living donor liver transplantation.
abstract: Balloon-occluded retrograde transvenous obliteration (BRTO) has become a common and effective procedure for treating hepatic encephalopathy due to a portosystemic shunt related to cirrhosis of the liver. However, this method of treatment has rarely been reported in patients after liver transplantation. Here, we report the case of a 52-year-old patient who underwent living donor liver transplantation (LDLT) due to hepatitis C virus-infected hepatocellular carcinoma that was complicated with portal vein thrombosis and a large portosystemic shunt between the superior mesenteric vein (SMV) and inferior vena cava (IVC). The SMV-IVC shunt was not obliterated during LDLT because there was sufficient portal flow into the graft after reperfusion. However, the patient was postoperatively complicated with encephalopathy due to the portosystemic shunt. BRTO was performed and was demonstrated to have effectively managed the encephalopathy due to the SMV-IVC shunt, while preserving the hepatic function after LDLT.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan, jasulan777@gmail.com.
authors.forename: Zhassulan
authors.initials: Z
authors.lastname: Baimakhanov
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Inoue
authors.forename: Hajime
authors.initials: H
authors.lastname: Matsushima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.forename: Amane
authors.initials: A
authors.lastname: Kitasato
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Adachi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakomoto
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
mesh_terms: D021721:Balloon Occlusion / Q000379:methods; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008642:Mesenteric Veins; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery*; D016157:Vascular Fistula / Q000150:complications*; D014682:Vena Cava, Inferior