Fujimoto M, Moriyasu F, Someda H, Nada T, Okuma M, Uemoto S, Inomata Y, Tanaka K, Yamaoka Y, Ozawa K
First Department of Internal Medicine, Kyoto University School of Medicine, Japan.
Transpl Int. 1995;8(2):119-25. doi: 10.1007/BF00344421.
Percutaneous transluminal angioplasty was performed for venous stenosis after living related liver transplantation in three children. Two of them had hepatic vein stenosis and one had stenosis of both the hepatic and portal veins. Progressive development of ascites and deterioration of liver function were found in all cases. Serial Doppler ultrasound studies showed that the flow velocity in the hepatic vein gradually decreased with a flattened velocity waveform, followed by a decrease in portal blood flow. After a successful hepatic vein angioplasty, the velocity in the hepatic and portal veins increased and the Doppler waveform in the hepatic vein became pulsatile in two cases. In the remaining case, a remarkable recovery of both graft perfusion and clinical findings was achieved via combined hepatic vein and portal vein angioplasty. We conclude that balloon angioplasty is an effective alternative to surgery for post-transplant vascular stenosis and that Doppler ultrasound is useful in monitoring graft circulation.
对三名儿童进行了活体亲属肝移植术后静脉狭窄的经皮腔内血管成形术。其中两名患儿有肝静脉狭窄，一名患儿肝静脉和门静脉均有狭窄。所有病例均出现腹水进行性加重和肝功能恶化。连续多普勒超声研究显示，肝静脉血流速度逐渐降低，速度波形变平，随后门静脉血流减少。在两例成功进行肝静脉血管成形术后，肝静脉和门静脉血流速度增加，肝静脉多普勒波形变为搏动性。在其余病例中，通过联合肝静脉和门静脉血管成形术，移植肝灌注和临床症状均显著恢复。我们得出结论，球囊血管成形术是治疗移植后血管狭窄的一种有效的手术替代方法，多普勒超声有助于监测移植肝循环。
