Limits...
Portal flow steal after liver transplantation.

Kim B, Kim KW, Song GW, Lee SG - Clin Mol Hepatol (2015)

Bottom Line: Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome.Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ajou University Medical Center, Suwon, Korea.

ABSTRACT
Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome. Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.

No MeSH data available.


Related in: MedlinePlus

Recurrent portal steal via the inferior mesenteric vein-rectal varix in 38-year-old male patient who underwent living donor liver transplantation for portal hypertensive liver cirrhosis. (A) Doppler spectrogram obtained at graft portal vein shows somewhat diminished portal flow, measuring 18.8 cm/s. (B) Color Doppler ultrasound at level just below portomesenteric junction demonstrates reversed flow via distended inferior mesenteric vein (IMV). (C) On maximum intensity projection image of portal venous phase, markedly distended IMV is intuitively visualized, which continues to rectal varix (not covered). (D) On direct portogram obtained by injection of contrast agent at distal part of superior mesenteric vein (SMV), contrast flow from the SMV is mostly shunting to the IMV, indicating the significant portal flow steal. (E) After the successful embolization of the IMV, portal flow is directed to the liver. SMV, superior mesenteric vein; SMA, superior mesenteric artery; Ao, abdominal aorta; PV, portal vein; SV, splenic vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4612294&req=5

Figure 1: Recurrent portal steal via the inferior mesenteric vein-rectal varix in 38-year-old male patient who underwent living donor liver transplantation for portal hypertensive liver cirrhosis. (A) Doppler spectrogram obtained at graft portal vein shows somewhat diminished portal flow, measuring 18.8 cm/s. (B) Color Doppler ultrasound at level just below portomesenteric junction demonstrates reversed flow via distended inferior mesenteric vein (IMV). (C) On maximum intensity projection image of portal venous phase, markedly distended IMV is intuitively visualized, which continues to rectal varix (not covered). (D) On direct portogram obtained by injection of contrast agent at distal part of superior mesenteric vein (SMV), contrast flow from the SMV is mostly shunting to the IMV, indicating the significant portal flow steal. (E) After the successful embolization of the IMV, portal flow is directed to the liver. SMV, superior mesenteric vein; SMA, superior mesenteric artery; Ao, abdominal aorta; PV, portal vein; SV, splenic vein.

Mentions: On Doppler ultrasound study, portal flow velocity was weakened to 18.8 cm/sec, with preserved hepatopetal directional flow (Fig. 1A). The hepatic arterial and hepatic venous Doppler parameters and waveforms were normal. Under the suspicion of portal flow steal, the tributaries of the portal vein were evaluated thereafter. Upon inspecting the superior mesenteric vein (SMV) at the level just below the portomesenteric junction, abnormally dilated inferior mesenteric vein (IMV) inserting to the SMV was noticed. On color Doppler study, hepatofugal directional flow was evident, stealing the portal flow away from the graft (Fig. 1B). Subsequent CT revealed marked engorgement of the IMV, in line with the Doppler ultrasound findings (Fig. 1C).


Portal flow steal after liver transplantation.

Kim B, Kim KW, Song GW, Lee SG - Clin Mol Hepatol (2015)

Recurrent portal steal via the inferior mesenteric vein-rectal varix in 38-year-old male patient who underwent living donor liver transplantation for portal hypertensive liver cirrhosis. (A) Doppler spectrogram obtained at graft portal vein shows somewhat diminished portal flow, measuring 18.8 cm/s. (B) Color Doppler ultrasound at level just below portomesenteric junction demonstrates reversed flow via distended inferior mesenteric vein (IMV). (C) On maximum intensity projection image of portal venous phase, markedly distended IMV is intuitively visualized, which continues to rectal varix (not covered). (D) On direct portogram obtained by injection of contrast agent at distal part of superior mesenteric vein (SMV), contrast flow from the SMV is mostly shunting to the IMV, indicating the significant portal flow steal. (E) After the successful embolization of the IMV, portal flow is directed to the liver. SMV, superior mesenteric vein; SMA, superior mesenteric artery; Ao, abdominal aorta; PV, portal vein; SV, splenic vein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612294&req=5

Figure 1: Recurrent portal steal via the inferior mesenteric vein-rectal varix in 38-year-old male patient who underwent living donor liver transplantation for portal hypertensive liver cirrhosis. (A) Doppler spectrogram obtained at graft portal vein shows somewhat diminished portal flow, measuring 18.8 cm/s. (B) Color Doppler ultrasound at level just below portomesenteric junction demonstrates reversed flow via distended inferior mesenteric vein (IMV). (C) On maximum intensity projection image of portal venous phase, markedly distended IMV is intuitively visualized, which continues to rectal varix (not covered). (D) On direct portogram obtained by injection of contrast agent at distal part of superior mesenteric vein (SMV), contrast flow from the SMV is mostly shunting to the IMV, indicating the significant portal flow steal. (E) After the successful embolization of the IMV, portal flow is directed to the liver. SMV, superior mesenteric vein; SMA, superior mesenteric artery; Ao, abdominal aorta; PV, portal vein; SV, splenic vein.
Mentions: On Doppler ultrasound study, portal flow velocity was weakened to 18.8 cm/sec, with preserved hepatopetal directional flow (Fig. 1A). The hepatic arterial and hepatic venous Doppler parameters and waveforms were normal. Under the suspicion of portal flow steal, the tributaries of the portal vein were evaluated thereafter. Upon inspecting the superior mesenteric vein (SMV) at the level just below the portomesenteric junction, abnormally dilated inferior mesenteric vein (IMV) inserting to the SMV was noticed. On color Doppler study, hepatofugal directional flow was evident, stealing the portal flow away from the graft (Fig. 1B). Subsequent CT revealed marked engorgement of the IMV, in line with the Doppler ultrasound findings (Fig. 1C).

Bottom Line: Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome.Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ajou University Medical Center, Suwon, Korea.

ABSTRACT
Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome. Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.

No MeSH data available.


Related in: MedlinePlus