Korean J Transplant.  2023 Nov;37(Suppl 1):S67. 10.4285/ATW2023.F-6424.

Clinical outcomes after living donor liver transplantation for Budd-Chiari syndrome

• OH Rk
• Yoon YI

• KMID: 2551654
• DOI: http://doi.org/10.4285/ATW2023.F-6424

Abstract

Background
Budd-Chiari syndrome (BCS) refers to complete thrombotic obstruction of the venous hepatic outflow tract due to various causes and is an uncommon indication for liver transplantation (LT). These patients present problems such as vascular thrombosis and biliary tract complications. The aim of this study was to review our center experience in LT for BCS.
Methods
Twenty BCS patients who underwent LDLT between March 2001 and February 2023 were analyzed. We analyzed potential effects of disease etiology, vascular events, graft type on long-term survival after transplantation. It contained all patient’s liver transplanted for BCS at Asan Medical Center.
Results
Of the 20 patients, 65% were female and 35% were male. Median age at the time of transplantation was 47 years. Median follow-up time was 111 months. The median model for end-stage liver disease score was 12.5 points. Primary BCS was observed in 17 patients (85%). Caval replacement was performed in six patients (30%). Sixteen patients used the right graft, three patients received dual LT, and one patient received Lt. graft was used. The median graft-to-recipient weight ratio was 1.12 points. The median hospital stay was 38 days including before and after surgery. During liver transplantation, median trans-fused RBD was 10.5 packs. The least amount of transfusion was not transfused, while the most amount of transfusion was 134 RBC packs. After surgery, BD anastomotic stricture occurred in six patients, and bile duct problems were identified as the most common complication after surgery. It was confirmed that 70% of patients were taking warfarin even after surgery. We have observed no recurrence of disease in our BCS patients. Our actual survival rate for BCS group was 95% at 5 years.
Conclusions
Liver transplantation is a good option for BCS with treatment strategy for patients with BCS provides good out-comes.