{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:02:42Z","timestamp":1788397362417,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T00:00:00Z","timestamp":1399852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2014,8]]},"abstract":"Abstract<\/jats:title>HVOO<\/jats:styled-content> creates significant diagnostic and management dilemmas in pediatric liver transplant recipients, particularly with TVG<\/jats:styled-content>s (split or reduced\u2010size grafts). Numerous technical variations for the hepatic vein to IVC<\/jats:styled-content> anastomosis have been described to minimize the incidence of this complication, but no consensus for an optimal anastomotic technique exists. One hundred and thirty\u2010four liver transplants (70 TVG<\/jats:styled-content>s) were performed in 124 patients between 1994 and 2011. These were divided into two cohorts. Group 1 (95 transplants, 41 TVG<\/jats:styled-content>s) utilized a continuous running anastomosis. Group 2 (39 transplants, 29 TVG<\/jats:styled-content>s) implemented a triangulated (three\u2010stitch) anastomosis. All were reviewed for demographics, diagnostics, interventions, and outcome. The overall HVOO<\/jats:styled-content> incidence was seven of 134 transplants (5.2%) and six of 70 transplants utilizing TVG<\/jats:styled-content>s (8.6%). Group 1 incidence was five of 41 (12.2%) compared with one of 29 (3.4%; p\u00a0=\u00a00.20, OR<\/jats:styled-content> 3.89) in Group 2. Liver Doppler was employed in all patients, and only three suggested HVOO<\/jats:styled-content>. All patients with HVOO<\/jats:styled-content> underwent venogram, at a median of 81\u00a0days post\u2010transplant. All underwent percutaneous venoplasty and required 1\u20136 treatments, all resulting in HVOO<\/jats:styled-content> resolution. Incidence of HVOO<\/jats:styled-content> has improved since adopting the triangulated anastomosis, although not to a level of statistical significance. US is not adequately sensitive to exclude HVOO<\/jats:styled-content>. Venogram is recommended in patients with prolonged ascites, and venoplasty has been highly successful in HVOO<\/jats:styled-content> treatment.<\/jats:p>","DOI":"10.1111\/petr.12277","type":"journal-article","created":{"date-parts":[[2014,5,12]],"date-time":"2014-05-12T08:24:38Z","timestamp":1399883078000},"page":"497-502","source":"Crossref","is-referenced-by-count":30,"title":["Hepatic venous outflow obstruction in pediatric liver transplantation: Technical considerations in prevention, diagnosis, and management"],"prefix":"10.1111","volume":"18","author":[{"given":"J.","family":"Sommovilla","sequence":"first","affiliation":[{"name":"Department of Surgery Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Vachharajani","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Radiology Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nadler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. P.","family":"Turmelle","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Weymann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. C.","family":"Chapman","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Lowell","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University in St Louis St Louis Children's Hospital St Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199009000-00015"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04268.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-010-2564-y"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200211000-00017"},{"key":"e_1_2_7_6_1","first-page":"11","article-title":"Reconstruction of the hepatic vein in reduced size hepatic transplantation","volume":"176","author":"Emond JC","year":"1993","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2012.01761.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2012.01742.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1051-0443(07)61652-2"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-985746"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.11.047"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2009.01259.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.tvir.2007.09.018"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21560"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpetr.12277","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.12277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T23:11:34Z","timestamp":1695510694000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.12277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,12]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1111\/petr.12277"],"URL":"https:\/\/doi.org\/10.1111\/petr.12277","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,12]]}}}