Korean J Transplant.  2022 Nov;36(Supple 1):S280. 10.4285/ATW2022.F-4241.

Nonsurgical removal of migrated polytetrafluoroethylene graft used for middle hepatic vein reconstruction in stomach 10 years after living donor liver transplantation

• Hong G
• Song SH

• KMID: 2535507
• DOI: http://doi.org/10.4285/ATW2022.F-4241

Abstract

Most centers use polytetrafluoroethylene (PTFE) grafts for middle hepatic vein reconstruction in living donor liver transplantation (LDLT). PTFE graft may cause some complications such as thrombosis, infection, migration, etc. There are some reports that the complications result in life-threatening septic shock. The migrations of PTFE graft into hollow viscous organs usually are managed by surgery. We present nonsurgical removal of migrated PTFE graft in stomach 10 years after LDLT. Recipient was 61-year-old female who had underwent LDLT in other hospital. The etiology was hepatitis B virus-related liver cirrhosis and hy-persplenism. There was still huge portal vein shunt after liver transplantation, and she suffered intermittent biliary stricture and thrombocytopenia. She took multiple interventions such as endoscopic retrograde choangiopancreatography, percutaneous transhepatic biliary drainage, partial splenic embolization, splenorenal shunt embolization, etc. Recently, she complained in-termittent upper abdominal discomfort, therefore, we performed an esophagogastroduodenoscopy (EGD). There was an invaginated foreign material at lesser curvature of stomach. Patient was evaluated whole abdomen by magnetic resonance image (MRI). We assumed there are severe adhesions in the abdomen because the patient suffered various complications after LT and underwent multiple interventional treatment. The PTFE graft was set apart from inferior vena cava from the review of MRI. Endoscopist performed EGD again and removed PTFE graft by gentle traction with snare. The patient took serial X-ray exams after endoscopy, there was no free air in the abdomen. There was no related complications 4 months after PTFE removal endo-scopic nonsurgical removal of migrated PTFE graft in the stomach after LDLT is safe procedure in highly selected patients.