Hepatic venous outflow obstruction is a relatively uncommon but important and devastating complication occurring after liver
transplantation. Recently, right lateral sector liver grafts have sometimes been used in living-donor liver transplantation
(LDLT), but, to our knowledge, early hepatic venous outflow obstruction has never been reported in right lateral sector LDLT.
A 58-year-old woman was diagnosed with liver cirrhosis and hepatocellular carcinoma and underwent right lateral sector LDLT.
Postoperatively, she developed liver dysfunction. Doppler ultrasound examination revealed flat waveforms and low-flow velocity
in the right hepatic vein (RHV). A computed tomography (CT) scan revealed a ventrally distorted RHV due to hypertrophy of
the liver graft. Hepatic venous obstruction was suspected and a hepatic venogram was performed. The venogram revealed stenosis
of the RHV due to the distortion of the vein. We performed percutaneous transfemoral balloon dilatation, but this was not
effective. We then inserted an expandable metallic stent (EMS) into the RHV. After the EMS placement, the condition of the
patient improved. Venogram and CT data suggested that the obstruction of the RHV developed because of distortion of the RHV
to the ventral side during liver regeneration.
Key words Hepatic venous outflow - Obstruction - Expandable metallic stent - Right lateral sector