Başkent Üniversitesi Yayınları

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search.filters.applied.f.language: search.filters.language.en_USSubject: search.filters.subject.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.