{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:31:22Z","timestamp":1787725882436,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T00:00:00Z","timestamp":1444953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatic venous outflow obstruction (<jats:styled-content style=\"fixed-case\">HVOO<\/jats:styled-content>) is a rare but serious complication in liver transplantation (<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of<jats:styled-content style=\"fixed-case\">HVOO<\/jats:styled-content>with venography and gradient measurement in consecutive<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>from a single centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred and six<jats:styled-content style=\"fixed-case\">LTs<\/jats:styled-content>were performed in 486 patients with a median age of 49 years (range 3 months to 71 years). Nineteen (3.8%) cases of<jats:styled-content style=\"fixed-case\">HVOO<\/jats:styled-content>were identified. Diagnosis was confirmed at a median of 26 days post\u2010<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>(1\u20132312). The incidence fell from 5.5% in the first 253<jats:styled-content style=\"fixed-case\">LT<\/jats:styled-content>, to 2.0% in the second 253 (<jats:italic>P<\/jats:italic>= 0.03). Seventeen were due to narrowing at the anastomosis and two cases were due to thrombosis. In adult patients, reconstruction of the supra\u2010hepatic donor inferior vena cava (<jats:styled-content style=\"fixed-case\">IVC<\/jats:styled-content>) onto two veins versus modified 2\u20133 hepatic veins did not alter the likelihood of<jats:styled-content style=\"fixed-case\">HVOO<\/jats:styled-content>. 17\/19 cases were managed successfully by stenting or venoplasty. Two paediatric patients with early onset<jats:styled-content style=\"fixed-case\">HVOO<\/jats:styled-content>had attempted surgical thrombectomy, one was successful and the other required retransplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of<jats:styled-content style=\"fixed-case\">HVOO<\/jats:styled-content>appears to fall with increasing experience and does not appear to be related to the number of veins the donor<jats:styled-content style=\"fixed-case\">IVC<\/jats:styled-content>is anastomosed to in adult recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13344","type":"journal-article","created":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T07:09:04Z","timestamp":1444979344000},"page":"182-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Hepatic venous outflow obstruction in piggyback liver transplantation: single centre experience"],"prefix":"10.1111","volume":"87","author":[{"given":"Joel","family":"Arudchelvam","sequence":"first","affiliation":[{"name":"New Zealand Liver Transplant Unit Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bartlett","sequence":"additional","affiliation":[{"name":"New Zealand Liver Transplant Unit Auckland City Hospital Auckland New Zealand"},{"name":"Department of Surgery Faculty of Medicine and Health Sciences University of Auckland Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McCall","sequence":"additional","affiliation":[{"name":"New Zealand Liver Transplant Unit Auckland City Hospital Auckland New Zealand"},{"name":"Department of Surgery University of Otago Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Johnston","sequence":"additional","affiliation":[{"name":"New Zealand Liver Transplant Unit Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Gane","sequence":"additional","affiliation":[{"name":"New Zealand Liver Transplant Unit Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Munn","sequence":"additional","affiliation":[{"name":"New Zealand Liver Transplant Unit Auckland City Hospital Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,16]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"659","article-title":"Homotransplantation of the liver in humans","volume":"117","author":"Starzl T","year":"1963","journal-title":"Surg. 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