Petrovic Igor, Brekalo Klara, Romic Ivan, Silovski Hrvoje, Sesa Vibor, Galunic Cicak Ruzica, Bulic Kresimir, Koltay Oliver M, Strajher Iva Martina, Mrzljak Anna
Department of Hepatobiliary Surgery and Transplantation, University Hospital Center Zagreb, University of Zagreb, Medical school Zagreb, Zagreb 10000, Croatia.
Department of Surgery, University of Zagreb School of Medicine, Zagreb 10000, Croatia.
World J Clin Cases. 2025 Oct 16;13(29):108608. doi: 10.12998/wjcc.v13.i29.108608.
Hepatic venous outflow obstruction (HVOO) is a rare but serious complication of liver transplantation, particularly in piggyback liver transplantation techniques where the inferior vena cava (IVC) is preserved.
A transplanted liver patient underwent retransplantation due to hepatic artery thrombosis and subsequently developed HVOO caused by graft compression of the IVC. A novel approach using a retrohepatic tissue expander effectively relieved the IVC compression, restored venous outflow, and stabilized hemodynamics. We discuss this case in the context of current treatment options and advances in HVOO management, from endovascular interventions such as balloon dilation and stenting to innovative surgical solutions such as graft repositioning and retrohepatic implants.
This case shows how important personalized treatments are for managing HVOO and how tissue expanders can be an adjustable and less invasive option.
肝静脉流出道梗阻（HVOO）是肝移植罕见但严重的并发症，尤其是在保留下腔静脉（IVC）的背驮式肝移植技术中。
一名肝移植患者因肝动脉血栓形成接受再次移植，随后因移植肝压迫IVC导致HVOO。一种使用肝后组织扩张器的新方法有效缓解了IVC压迫，恢复了静脉流出，并稳定了血流动力学。我们结合当前的治疗选择以及HVOO管理的进展来讨论该病例，这些进展包括诸如球囊扩张和支架置入等血管内介入治疗，以及诸如移植肝重新定位和肝后植入物等创新手术解决方案。
该病例表明个性化治疗对于管理HVOO非常重要，以及组织扩张器如何能够成为一种可调节且侵入性较小的选择。
