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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 2/2024

30-10-2023 | Hepatic Encephalopathy | LETTER TO THE EDITOR

Intracardiac Echocardiography Guidance for Percutaneous Closure of Surgical Portocaval Shunt after Liver Transplant

Authors: David Leon, Mari Tanaka, Ashraf Thabet, Adel Bozorgzadeh, Daniel S. Pratt, Sanjeeva P. Kalva, Vincent Wu

Published in: CardioVascular and Interventional Radiology | Issue 2/2024

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Excerpt

Small for size graft syndrome (SFSS) is caused by a partial living-donor liver graft that is “too small” to sustain the metabolic demands of the recipient [1]. This syndrome presents as prolonged cholestasis, coagulopathy, and ascites within the first week of liver transplant [2]. SFFS is managed surgically with portosystemic shunt creation, which carries the risk of hepatic encephalopathy (HE) in the long run [3]. Surgical shunt ligation can be technically challenging and high risk in poor operative candidates. Here, we report a case of endovascular portocaval shunt closure using an Amplatzer atrial septal defect (ASD) occluder under intracardiac echocardiography (ICE) guidance. …
Literature
1.
Masuda Y, et al. Small-for-size syndrome in liver transplantation: definition, pathophysiology and management. Hepatobiliary Pancreat Dis Int. 2020;19(4):334–41.CrossRefPubMed
2.
Hernandez-Alejandro R, Sharma H. Small-for-size syndrome in liver transplantation: new horizons to cover with a good launchpad. Liver Transpl. 2016;22(S1):33–6.CrossRefPubMed
3.
Oura T, et al. Does the permanent portacaval shunt for a small-for-size graft in a living donor liver transplantation do more harm than good? Am J Transplant. 2008;8(1):250–2.CrossRefPubMed
4.
Botha JF, et al. Endovascular closure of a hemiportocaval shunt after small-for-size adult-to-adult left lobe living donor liver transplantation. Liver Transpl. 2009;15(12):1671–5.CrossRefPubMed
5.
Durack J, et al. Endovascular closure of a portocaval shunt after left lobe liver transplantation using an Amplatzer muscular ventricular septal occluder device. Liver Transpl. 2011;17(2):211–4.CrossRefPubMed
Metadata
Title
Intracardiac Echocardiography Guidance for Percutaneous Closure of Surgical Portocaval Shunt after Liver Transplant
Authors
David Leon
Mari Tanaka
Ashraf Thabet
Adel Bozorgzadeh
Daniel S. Pratt
Sanjeeva P. Kalva
Vincent Wu
Publication date
30-10-2023

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