Related Experiment Video
Updated: Jun 13, 2026
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Living donor liver transplantation in Budd-Chiari syndrome: a single-center experience
1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Living donor liver transplantation (LDLT) is a viable option for Budd-Chiari syndrome (BCS) patients. Surgical modifications enable successful LDLT for BCS, achieving excellent patient and graft survival rates.
Area of Science:
- Hepatology
- Transplantation Surgery
- Vascular Surgery
Background:
- Budd-Chiari syndrome (BCS) involves hepatic venous outflow obstruction, often treated with caval resection, precluding liver transplantation.
- Living donor liver transplantation (LDLT) presents unique challenges for BCS patients due to potential caval involvement.
Purpose of the Study:
- To evaluate the safety and efficacy of LDLT in BCS patients.
- To describe surgical modifications for LDLT in BCS, addressing hepatic venous and inferior vena cava (IVC) obstruction.
Main Methods:
- Retrospective analysis of 4 BCS patients undergoing LDLT between January 2003 and December 2007.
- Surgical techniques included RHV resection with IVC anastomosis, retrohepatic IVC reconstruction, and mesoatrial shunt conversion.
Main Results:
- All 4 patients successfully underwent LDLT for BCS.
- 100% patient and graft survival rates were observed.
- Minimal complications occurred in donors and recipients.
Conclusions:
- LDLT is a safe and effective treatment for BCS when employing appropriate venous drainage techniques.
- Anticoagulant therapy and diligent follow-up are crucial for managing BCS post-LDLT and preventing recurrence.
Abstract:
Budd-Chiari syndrome (BCS), which is characterized by hepatic venous outflow obstruction due to occlusion of the major hepatic vein and/or the inferior vena cava (IVC), is rare. Traditionally, a caval resection is advocated for these patients; however, such a maneuver renders living donor liver transplantation (LDLT) impossible. We encountered BCS in 4/377 LDLT patients during a 5-year period (January 2003 to December 2007). This report examine the various surgical modifications in these 4 patients, who underwent to LDLT for BCS. Resection of right hepatic vein (RHV) with an adjacent fibrotic part of the IVC with direct anastomosis of the graft RHV to the IVC was performed in 2 patients. One patient underwent retrohepatic IVC excision and reconstruction with a cryopreserved autologous IVC graft. The fourth patient, with a preexisting mesoatrial shunt for BCS, underwent conversion of this to a RHV atrial shunt. Graft and patient survivals were 100%. There were few complications in either donors or recipients. LDLT for BCS can be performed safely with adequate venous drainage techniques and with anticoagulant therapy and good follow-up for early diagnosis and treatment of recurrence leading to excellent long-term results.
