To Study The Evalutation Of Interventional Treament For Hepatic Venous Outflow Obstruction After Exvivo Resection And Autotransplantation

Objective: To investigate the causes of hepatic venous outflow obstruction(HVOO)after ex vivo liver resection and autotransplantation(ELRA),the clinical value of interventional therapy in its application.Methods: From April 2016 to April 2021,12patients(12/88)who developed HVOO after undergoing ELRA at the First Affiliated Hepatobiliary Hydatid Disease Surgery Department of Xinjiang Medical University were retrospectively analyzed;the outflow tract reconstruction methods and causes of obstruction were analyzed.and clinical outcomes of interventional therapy.Results:Among the patients with hepatic venous outflow tract obstruction,11 patients received interventional therapy,one patient was forced to undergo a secondary liver transplantation due to problems with liver failure.Among the hepatic vein reconstruction methods,7cases(58.3%)were repaired by self-suture,and 5 cases(41.7%)were reconstructed with autologous vascular patch;among the inferior vena cava reconstruction methods,8 cases(66.7%)were replaced by artificial blood vessels.%),1 case used allogeneic blood vessels to reconstruct the inferior vena cava(8.3%),3 cases were repaired by self-suture(25%);the hepatic vein was anastomosed with the inferior vena cava in an end-to-side manner.A total of 18 interventional treatments were performed in 11 patients,the technical success rate achieved with the first treatment was 100%(18 / 18),and the clinical success rate was54.5%.The hepatic venous outflow tract pressure gradient decreased from19.1±16.5mm Hg to 2.2±1.5mm Hg(P<0.001).During an average follow-up of 15 months,there were no complications related to interventional therapy.The final achieved clinical success rate achieved corresponds to 90.9%.During the follow-up,one patient was lost to follow-up with a continuous 20-month follow-up,and 1 patient died of upper gastrointestinal bleeding.Conclusion: For patients with HVOO after ELRA,vascular interventional therapy can achieve satisfactory clinical efficacy.