Interventional radiology procedures in adult patients who underwent liver transplantation

Figure 5 Status post deceased donor right lobe split LT in 65-year-old female. Three separates HV anastomoses were performed. One month after LT, patient developed refractory ascites and right pleural effusion with worsening of liver function tests. Doppler US was suspicious of HVs. A cavogram performed from the femoral approach showed widely patent IVC anastomosis. Selective catheterization of the three HVs (A, C and E) showed stenosis in the three anastomoses with trans-stenotic pressure gradient of 15, 20 and 16 mmHg, respectively. Balloon angioplasties were performed with balloon catheters ranging from 7 to 10 mm in diameter. Final venogram showed patent anastomoses (B, D and F). Trans-anastomotic pressure gradient reduced to 4, 2.5 and 8 mmHg. Eight months of follow-up without recurrence of refractory ascites and/or hydrothorax.