Replacement of the Vena Cava with Aortic Graft for Living Donor Liver Transplantation in Budd-Chiari Syndrome Associated with Hydatid Cyst Surgery: A Case Report

Abstract A 12-year-old girl, operated because of a hydatid cyst of the liver, with Budd-Chiari syndrome was evaluated for postoperative development of ascites and paraumbilical varicose veins. A vena caval stent was placed for the relief of inferior vena caval obstruction. The patient was admitted b...

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Bibliographic Details
Published in:Transplantation proceedings 2012-07, Vol.44 (6), p.1757-1758
Main Authors: Sakçak, I, Eriş, C, Ölmez, A, Kayaalp, C, Yılmaz, S
Format: Article
Language:English
Subjects:
Aorta - transplantation
Biological and medical sciences
Bioprosthesis
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Budd-Chiari Syndrome - etiology
Budd-Chiari Syndrome - surgery
Child
Cryopreservation
Echinococcosis, Hepatic - surgery
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Gastroenterology. Liver. Pancreas. Abdomen
Hepatectomy
Hepatic Veins - surgery
Humans
Iatrogenic Disease
Liver Transplantation - methods
Liver, biliary tract, pancreas, portal circulation, spleen
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Living Donors
Medical sciences
Other diseases. Semiology
Postoperative Complications - etiology
Postoperative Complications - surgery
Prosthesis Design
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tissue, organ and graft immunology
Treatment Outcome
Ultrasonography, Doppler
Vena Cava, Inferior - diagnostic imaging
Vena Cava, Inferior - surgery
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Summary:Abstract A 12-year-old girl, operated because of a hydatid cyst of the liver, with Budd-Chiari syndrome was evaluated for postoperative development of ascites and paraumbilical varicose veins. A vena caval stent was placed for the relief of inferior vena caval obstruction. The patient was admitted because of progressive deterioration in ascites and liver functions. Imaging techniques showed degeneration adjacent to the right hepatic vein in liver segments 7 to 8, a partially calcified 5-cm hydatid cyst, and a thrombosis in the inferior vena cava was that addressed with a 10-cm metal stent. A living donor segments 2 to 3 liver transplantation was obtained from the patient's mother. After completion of the donor operation without complications, the vena caval stent was removed following the recipient hepatectomy. Suprarenal flow continued after resection of the fibrotic vena cava and placement of a cadaveric cryopreserved aortic graft for the vena cava, anastomosed between the suprarenal and subdiaphragmatic segments of the vena cava. An end-to-side anastomosis was performed between the left hepatic vein of the donor liver and the aortic graft. There was no complication and the patient was discharged on postoperative day 19. Follow-up Doppler ultrasonography showed the aortic vena caval graft to be open, along with the hepatic/portal vein and hepatic artery. This case demonstrated that operations for liver hydatid cyst surgeries can iatrogenically induce Budd-Chiari syndrome; a cryopreserved aortic graft can be an alternative to ensure the continuity of the vena cava in living donor liver transplantation.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2012.04.023