Masashi Fujimori MD, Presenter: Nothing to Disclose

Shugo Mizuno, Abstract Co-Author: Nothing to Disclose

Atsuhiro Nakatsuka MD, Abstract Co-Author: Nothing to Disclose

Haruyuki Takaki MD, Abstract Co-Author: Nothing to Disclose

Junji Uraki MD, Abstract Co-Author: Nothing to Disclose

Takashi Yamanaka MD, Abstract Co-Author: Nothing to Disclose

Takaaki Hasegawa, Abstract Co-Author: Nothing to Disclose

Hajime Sakuma MD, Abstract Co-Author: Departmental Research Grant, Siemens AG Departmental Research Grant, Koninklijke Philips Electronics NV Departmental Research Grant, General Electric Company Departmental Research Grant, Bayer AG Departmental Research Grant, Eisai Co, Ltd Departmental Research Grant, Guerbet SA

Shuji Isaji, Abstract Co-Author: Nothing to Disclose

Koichiro Yamakado MD, PhD, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate the clinical efficacy of metallic stent placement for the treatment of hepatic venous outflow block after living-donor-liver transplantation (LDLT).

This study was approved by our institutional review board, which waived the requirement for informed consent to use data for research purposes. From 2002 to 2012, 15 patients with a mean age of 51±30.8 years (range, 4-69 years) underwent stent placement for the treatment of outflow block 1-341 days after LDLT with a mean interval of 24±54.7 days. Venous stenosis with a pressure gradient of 10mmHg or more was found in the inferior vena cava in 7 patients, hepatic vein in 7 patients, and in both in 1 patient. Stents were percutaneously placed across stenosis. Technical success (pressure gradient<3mHg), complication, improvement in clinical manifestation , stent patency, and survival were evaluated.

Technical success was achieved in all 15 patients (100%, 15/15). There was no death or major complications related to stent placement. The mean pressure gradient significantly decreased from 13±8mmHg (range, 10-24 mmHg) to 0.8±2mmHg (range, 0-2 mmHg) (p<0.0001) immediately after stenting. Clinical manifestation improved 1-81 days (mean, 17 days) in 10 patients (66.7%, 10/15), and they are all alive. The remaining 5 patients died of sepsis (60%, 3/5), gastrointestinal bleeding (20%, 1/5), and chronic rejection (20%, 1/5). Stents remained patent during the follow-up of 1.3-115.5 months (median, 38 months). The 5-year overall survival rate was 71.1% (95% confidence interval: 46.2-96.0%).

Stenting is a safe and useful treatment to resolve outflow block after LDLT and helps to improve prognosis of such patients.

Metalic stent placemet is a safe and useful treatment to resolve hepatic venous outflow block after LDLT and helps to improve prognosis of such patients.

Fujimori, M, Mizuno, S, Nakatsuka, A, Takaki, H, Uraki, J, Yamanaka, T, Hasegawa, T, Sakuma, H, Isaji, S, Yamakado, K, Metallic Stent Placement for the Treatment of Hepatic Venous Outflow Block after Living-Donor-Liver Transplantation.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13021541.html