title: Long-Term Results of Stent Placement in Patients with Outflow Block After Living-Donor-Liver Transplantation.
abstract: OBJECTIVE
  To evaluate long-term results of stent placement retrospectively in patients with outflow block after living-donor-liver transplantation (LDLT).
  
  
  METHODS
  For this institutional review board approved retrospective study conducted during 2002-2012, stents were placed in outflow veins in 15 patients (11.3%, 15/133) (12 men; 3 female) in whom outflow block developed after LDLT. Their mean age was 52.3 years ± 15.3 (SD) (range, 4-69 years). Venous stenosis with a pressure gradient ≥5 mmHg (outflow block) was observed in the inferior vena cava in seven patients, hepatic vein in seven patients, and both in one patient. Technical success, change in a pressure gradient and clinical manifestations, and complications were evaluated. Overall survival of 15 patients undergoing outflow block stenting was compared with that of 116 patients without outflow block after LDLT.
  
  
  RESULTS
  Stents were placed across the outflow block veins without complications, lowering the pressure gradient ≤ 3 mmHg in all patients (100%, 15/15). Clinical manifestations improved in 11 patients (73.3%, 11/15), and all were discharged from the hospital. However, they did not improve in the other 4 patients (26.7%, 4/15) who died in the hospital 1.0-3.7 months after stenting (mean, 2.0 ± 1.2 months). No significant difference in 5-year survival rates was found between patients with and without outflow block after LDLT (61.1 vs. 72.2%, p = .405).
  
  
  CONCLUSIONS
  Stenting is a feasible, safe, and useful therapeutic option to resolve outflow block following LDLT, providing equal survival to that of patients without outflow block.
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. fujimorim@clin.medic.mie-u.ac.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujimori
authors.affiliation: Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. yamakado47@gmail.com.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.affiliation: Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. takaki-h@clin.medic.mie-u.ac.jp.
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. nakatuka@clin.medic.mie-u.ac.jp.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakatsuka
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. junji@clin.medic.mie-u.ac.jp.
authors.forename: Junji
authors.initials: J
authors.lastname: Uraki
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. t-yama@clin.medic.mie-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamanaka
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. hasegawat@clin.medic.mie-u.ac.jp.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. ysugino23@clin.medic.mie-u.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sugino
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. k-nakajima@clin.medic.mie-u.ac.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Nakajima
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. n-matsushita@clin.medic.mie-u.ac.jp.
authors.forename: Naritaka
authors.initials: N
authors.lastname: Matsushita
authors.affiliation: Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, Tsu, Mie, Japan. mizunos@clin.medic.mie-u.ac.jp.
authors.forename: Shugo
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. sakuma.mie@gmail.com.
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakuma
authors.affiliation: Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, Tsu, Mie, Japan. isaji-s@clin.medic.mie-u.ac.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult
keywords: Liver transplantation; Stenting; Venous intervention