What are the prevalence and causes of inferior vena cava (IVC) complications following whole-liver orthotopic liver transplantation (OLTX)?

Updated: Nov 11, 2019
  • Author: Fazal Hussain, MD, MPH; Chief Editor: John Karani, MBBS, FRCR  more...
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Answer

The development of posttransplantation IVC stenosis or thrombosis is an uncommon complication that occurs in approximately 1-4% of cases. IVC stenosis and thrombosis tend to occur at the superior and inferior caval anastomoses. Causes include technical problems, IVC compression due to fluid collection or a hematoma, and mass effect from hepatic regeneration. Patients with suprahepatic lesions tend to present with signs and symptoms of Budd-Chiari syndrome; examples of these include pleural effusion, hepatic enlargement, and ascites. IVC obstruction can cause lower-extremity edema, which can be a prominent feature of infrahepatic stenosis. Clinically, leg swelling helps distinguish a suprahepatic caval complication from a PV problem; both of these complications are associated with features of portal hypertension. [24]


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