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Updated: Jun 12, 2026
Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
Percutaneous Transhepatic Recanalization for Hepatic Venous Outflow Obstruction after Living Donor Liver
Chinmay Bhimaji Kulkarni1, Sreekumar Karumathil Pullara1, Srikanth Moorthy1
1Department of Radiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Amrita Lane, Ponekkara, Cochin, Kerala State, India.
Purpose:
To evaluate effectiveness and safety of the percutaneous transhepatic technique for treating post-living donor liver transplantation (LDLT) hepatic venous outflow obstruction (HVOO).
Materials And Methods:
Hospital records of 1,228 patients who underwent LDLT between January 2013 and March 2026 were retrospectively reviewed. Among these, 27 patients who developed post-LDLT HVOO and treated with percutaneous recanalization were identified. Patient details and images were retrieved from institutional electronic records database and imaging archive system. Among 27 patients, 21 patients were adults with mean age of 51.3 years (SD ± 7.4), and 6 were pediatric patients with mean age of 4.8 years (SD ± 4). Twenty-six patients were treated with primary stent placement, and 1 patient was treated with angioplasty. Technical and clinical success, complications, primary patency of percutaneous recanalization, overall survival rates, and frequency of symptom recurrence were analyzed.
Results:
Technical success was achieved in all patients (27/27, 100%). Clinical success was achieved in 25 (92.5%) of 27 patients. Primary patency rates at 1, 3, and 5 years were 100%, 95.2%, and 95.2% (95% CI, ∼76%-99%), respectively. Kaplan-Meier analysis demonstrated overall survival rates of 88.9% (95% CI, ∼70%-96%) at 1 year and 84.8% (95% CI, ∼65%-93%) at both 3 and 5 years. Mean follow-up time was 33.7 months (SD ± 18.5; range, 0.5-76 months; median, 32 months). No procedure-related major complications were observed.
Conclusions:
Transhepatic approach is a safe and effective technique for treating HVOO after LDLT. Primary hepatic vein stent placement for HVOO after LDLT provides satisfactory long-term patency and favorable overall survival.
