{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:06:25Z","timestamp":1792058785680,"version":"4.4.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2016,5,26]],"date-time":"2016-05-26T00:00:00Z","timestamp":1464220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,5,26]],"date-time":"2016-05-26T00:00:00Z","timestamp":1464220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:p>Hepatic venous outflow obstruction (HVOO) is a critical complication after living donor liver transplantation (LDLT). This study aimed to evaluate the incidence of HVOO and the risk factors for HVOO in adults. From 2005 to 2015, 430 adult LDLT patients (right lobe [RL] graft, 270 patients; left lobe [LL] graft, 160 patients) were enrolled and divided into no HVOO (n = 413) and HVOO (n = 17) groups. Patient demographics and surgical data were compared, and risk factors for HVOO were analyzed. Furthermore, the longterm outcomes of percutaneous interventions as treatment for HVOO were assessed. HVOO occurred in 17 (4.0%) patients. The incidence of HVOO in patients receiving a LL graft was significantly higher than in those receiving a RL graft (8.1% versus 1.5%; <jats:italic toggle=\"yes\">P =<\/jats:italic> 0.001). The body weight and caliber of hepatic vein anastomosis in the HVOO group were significantly lower compared with the no HVOO group (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02 and <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.008, respectively). Multivariate analysis revealed that only LL graft was an independent risk factor for HVOO (OR, 4.782; 95% CI, 1.387\u201016.488; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.01). Among 17 patients with HVOO, 7 patients were treated with single balloon angioplasty, and 9 patients who developed recurrence were treated with repeated interventions. Overall, 6 patients underwent stent placement: 1 at the initial procedure, 3 at the second procedure for early recurrence, and 2 following repeated balloon angioplasty (\u22653 interventions). These 6 patients experienced no recurrence. Overall graft survival was not significantly different between the HVOO and no HVOO groups (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.99). In conclusion, the use of a LL graft was associated with HVOO, and percutaneous interventions were effective for treating adult HVOO after LDLT. <jats:italic toggle=\"yes\">Liver Transplantation 22 785\u2013795 2016 AASLD<\/jats:italic>.<\/jats:p>","DOI":"10.1002\/lt.24399","type":"journal-article","created":{"date-parts":[[2016,1,19]],"date-time":"2016-01-19T23:38:44Z","timestamp":1453246724000},"page":"785-795","source":"Crossref","is-referenced-by-count":36,"title":["Left lobe graft poses a potential risk of hepatic venous outflow obstruction in adult living donor liver transplantation"],"prefix":"10.1097","volume":"22","author":[{"given":"Toshihiro","family":"Kitajima","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimi","family":"Kaido","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Iida","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Yagi","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Fujimoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Mori","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Okajima","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinpei","family":"Imamine","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging and Nuclear Medicine,Kyoto University,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiya","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging and Nuclear Medicine,Kyoto University,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Uemoto","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic and Transplant Surgery, Department of Surgery,Graduate School of Medicine,Kyoto,Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,5,26]]},"reference":[{"key":"lt24399-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1016\/j.transproceed.2009.06.066","article-title":"Early venous outflow obstruction after liver transplantation and treatment with cavo\u2010cavostomy","volume":"41","year":"2009","journal-title":"Transplant Proc"},{"key":"lt24399-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1097\/00007890-200012150-00011","article-title":"Outflow tract reconstruction in living donor liver transplantation","volume":"70","year":"2000","journal-title":"Transplantation"},{"key":"lt24399-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.transproceed.2012.01.048","article-title":"Hepatic venous outflow obstruction in living donor liver transplantation: balloon angioplasty or stent placement?","volume":"44","year":"2012","journal-title":"Transplant Proc"},{"key":"lt24399-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/j.1399-0012.2010.01227.x","article-title":"Late\u2010onset venous outflow obstruction treated by placement of a Foley balloon catheter in living donor liver transplantation using a left lobe","volume":"24","year":"2010","journal-title":"Clin Transplant"},{"key":"lt24399-bib-0005-20240115","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1097\/01.TP.0000131162.35391.9D","article-title":"Surgical repair for late\u2010onset hepatic venous outflow block after living\u2010donor liver transplantation","volume":"77","year":"2004","journal-title":"Transplantation"},{"key":"lt24399-bib-0006-20240115","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S0039-6060(97)90353-6","article-title":"Hepatic vein reconstruction in 152 living\u2010related donor liver transplantation patients","volume":"121","year":"1997","journal-title":"Surgery"},{"key":"lt24399-bib-0007-20240115","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1002\/lt.22135","article-title":"Hepatic venous outflow obstruction in pediatric living donor liver transplantation using left\u2010sided lobe grafts: Kyoto University experience","volume":"16","year":"2010","journal-title":"Liver Transpl"},{"key":"lt24399-bib-0008-20240115","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1159\/000118033","article-title":"Maximizing venous outflow after right hepatic living donor liver transplantation with a venous graft patch","volume":"25","year":"2008","journal-title":"Dig Surg"},{"key":"lt24399-bib-0009-20240115","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1002\/lt.20374","article-title":"New hepatic vein reconstruction in left liver graft","volume":"11","year":"2005","journal-title":"Liver 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A new therapeutic strategy on portal flow modulation that increases donor safety with good recipient outcomes","volume":"97","year":"2014","journal-title":"Transplantation"},{"key":"lt24399-bib-0020-20240115","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1002\/lt.22059","article-title":"Portal pressure <15 mm Hg is a key for successful adult living donor liver transplantation utilizing smaller grafts than before","volume":"16","year":"2010","journal-title":"Liver Transpl"},{"key":"lt24399-bib-0021-20240115","doi-asserted-by":"crossref","first-page":"745","DOI":"10.2214\/AJR.08.2145","article-title":"Hepatic outflow obstruction at middle hepatic vein tributaries or inferior right hepatic veins after living donor liver transplantation with modified right lobe graft: comparison of CT and Doppler ultrasound","volume":"193","year":"2009","journal-title":"AJR Am J 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