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      Side-to-side cavocavostomy with an endovascular stapler: Rescue technique for severe hepatic vein and/or inferior vena cava outflow obstruction after liver transplantation using the piggyback technique.

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          Abstract

          Venous outflow obstruction is a rare but potentially lethal complication after orthotopic liver transplantation (OLT) with the "piggyback" technique. Therapeutic options include angioplasty with or without stent placement, surgical reconstruction of the venous anastomosis, and retransplantation. Surgical options are technically very challenging and the outcomes discouraging. We describe here two cases of venous outflow obstruction in recipients of piggyback liver grafts, one involving both the vena cava and hepatic veins and the other affecting only hepatic vein outflow. Both patients were treated successfully with side-to-side cavo-cavostomy using an endovascular (endo-GIA) stapler. This novel technique is fast and effective in resolving the outflow obstruction.

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          Author and article information

          Journal
          Liver Transpl.
          Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
          Wiley-Blackwell
          1527-6473
          1527-6465
          Jan 2009
          : 15
          : 1
          Affiliations
          [1 ] Department of General Surgery, Cleveland Clinic, Cleveland, OH 44195, USA. quintic@ccf.org
          Article
          10.1002/lt.21667
          19109837

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