Başkent Üniversitesi Yayınları

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Has files: YesSubject: search.filters.subject.Budd-Chiari syndrome

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    Living-donor Liver Transplant in 3 Patients With Budd-Chiari Syndrome: Case Report
    (Başkent Üniversitesi, 2012-04) Bas, Koray; Tokat, Yaman; Yuzer, Yildiray; Dogusoy, Gulen Bulbul; Ulusoy, Onur Levent; Dayangac, Murat; Yaprak, Onur
    Budd-Chiari syndrome is a rare but life-threatening disorder characterized by obstruction of the hepatic venous outflow. Treatment depends on the underlying cause, the location, and extent of the obstruction, and the functional capacity of the liver. A stepwise therapeutic approach is commonly accepted. When all other therapy options are unsuccessful, or in case of end-stage liver disease, transplant should be considered. We present case reports of 3 patients with Budd-Chiari syndrome who underwent living-donor liver transplant. Characteristic features of Budd-Chiari syndrome, diagnostic and therapeutic interventions, complications, and overall outcomes are discussed. We believe that when a deceased donor graft is unavailable, a living-donor liver transplant can be a safe option for patients with end-stage liver disease associated with Budd-Chiari syndrome.
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    Liver Transplant For Budd-Chiari Syndrome Caused by Paroxysmal Nocturnal Hemoglobinuria
    (Başkent Üniversitesi, 2008-09) Yedibela, Süleyman; Hohenberger, Werner
    Objectives: Paroxysmal nocturnal hemoglobinuria is a rare acquired nocturnal disorder of the hematopoietic stem cells. The major causes of associated morbidity and mortality are chronic intravascular hemolysis, pancytopenia, and venous thrombosis. Patients: We report on a 20-year-old man with advanced Budd-Chiari syndrome caused by paroxysmal nocturnal hemoglobinuria, who under­went an emergency liver transplant. Results: At the time of this writing, the patient has good primary hepatic function, and, although not receiving specific medication, shows no signs of pancytopenia. Anticoagulation with low-dose acetylsalicylic acid was initiated. Forty-eight months after the transplant, there are no signs of thromboembolic complications affecting the liver. Conclusions: Liver transplant is an appropriate treatment for Budd-Chiari syndrome caused by paroxysmal nocturnal hemoglobinuria. Sup­plemented by long-term low-dose anticoagulation treatment, liver transplant is superior to other surgical options, particularly when liver disease is advanced.
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    Reconstruction of the Hepatic Venous Outflow in Piggyback Liver Transplantation
    (Başkent Üniversitesi, 2004-06) Barshes, Neal R; Lee, Timothy; Kılıç, Murat; Goss, John A
    Objectives: The “piggyback” hepatic vein reconstruction and orthotopic liver transplantation (PBOLT) is a technique of liver transplantation that leaves the recipient inferior vena cava (IVC) intact, often avoiding the use of venovenous bypass (VVBP). Our study investigated whether patient morbidity and mortality after PB-OLT was comparable to that of the standard technique of orthotopic liver transplant (STD-OLT), which generally requires VVBP. Materials and Methods: We reviewed 220 consecutive adult OLTs performed at a single institution. In the PB-OLT technique, the IVC was left intact. The suprahepatic IVC was anastomosed to a cuff, fashioned from the confluence of the recipient left and middle hepatic veins. The donor infrahepatic IVC was oversewn. The STD-OLT technique was used when patient conditions precluded PB-OLT. VVBP was required in 83% of STD-OLT cases and no cases of PB-OLT.