What is the role of liver transplantation in the treatment of Budd-Chiari syndrome?

Updated: Oct 10, 2018
  • Author: Praveen K Roy, MD, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Liver transplantation should be offered if decompensated liver cirrhosis is present  [4, 41]  or as salvage treatment in the setting of failed portal derivative techniques. [48]  Posttransplantation anticoagulation is required in most patients with Budd-Chiari syndrome. [48]

In a Polish retrospective study (2000-2009), the long-term clinical outcomes (eg, patient and graft survival) following liver transplantation and anticoagulation maintenance for Budd-Chiari syndrome were good in 25 patients with myeloproliferative disease and recurrent thrombosis. [42]

Similar findings were reported in an Indian retrospective study (2011-2015) of 9 patients with Budd-Chiari syndrome and chronic liver disease who underwent living donor liver transplantation. [43]  The investigators noted that prevention of recurrent thrombosis was dependent on "meticulous surgical technique, perfect and wide outflow anastomoses, and a strict anticoagulation protocol. Moreover, the use of synthetic (PTFE) graft for inferior vena cava interposition was safe, feasible, and provided good reconstruction results. [43]


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