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Exp Clin Transplant 2021 May 6. Epub 2021 May 6.

From the Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, Saket, New Delhi, India.

Objectives: Adequate venous outflow is one of the most important factors responsible for optimal graft function in liver transplantation. Thrombosis of the inferior vena cava in cases of Budd-Chiari syndrome poses a major challenge to a transplant surgeon in establishing proper graft outflow. In deceased donor liver transplant, this problem can be dealt with relative ease as the liver graft includes donor inferior vena cava. Read More

Ann Surg 2021 Apr 1. Epub 2021 Apr 1.

*Organ Transplantation Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China †Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, Sichuan, China ‡Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR, China.

BMJ Case Rep 2021 Apr 26;14(4). Epub 2021 Apr 26.

Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Am J Gastroenterol 2021 Apr 21. Epub 2021 Apr 21.

Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, Maryland, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Introduction: A model that can predict short-term mortality in patients with the Budd-Chiari syndrome (BCS) with a high degree of accuracy is currently lacking. The primary objective of our study was to develop an easy-to-use in-hospital mortality prediction model in patients with BCS using easily available clinical variables.

Methods: Data were extracted from the National Inpatient Sample to identify all adult patients with a listed diagnosis of BCS from 2008 to 2017 using ICD-9 or ICD-10 codes. Read More

J Coll Physicians Surg Pak 2021 Apr;30(4):455-460

School of Medicine, Nankai University, China.

Balloon angioplasty with or without stent placement has become the mainstream treatment of Budd-Chiari syndrome (BCS). Restenosis of hepatic vein (HV) is a tough problem. The aim of this study was to perform a meta-analysis to compare the restenosis in HV involvement type BCS patients treated by balloon dilatation with versus without stent. Read More

J Postgrad Med 2021 Apr-Jun;67(2):122-123

Department of Medicine, Lady Hardinge Medical College and Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Case Rep Oncol 2021 Jan-Apr;14(1):47-55. Epub 2021 Feb 23.

Center for Liver Transplantation and Hepatobiliary Surgery, Mexico Hospital, Caja Costarricense del Seguro Social (CCSS), San José, Costa Rica.

We herein report the challenging evaluation and planning process involved in performing the first successful surgical resection of a renal tumor with extensive inferior vena cava tumor thrombosis reaching the right atrium in a pediatric patient within the Central American region. In November 2018, the Oncology Department of the National Children's Hospital in Costa Rica consulted our Center for Liver Transplantation and Hepatobiliary Surgery for the evaluation of a clinical case involving a 6-year-old female patient with progressive Budd-Chiari syndrome caused by a Wilms' tumor of the right kidney with tumor thrombosis of the inferior vena cava reaching the right atrium. A multistage surgical safety strategy combining liver transplant techniques and cardiac surgery was thereafter designed and implemented, achieving complete excision of the tumor thrombus from the inferior vena cava with right nephrectomy. Read More

Perfusion 2021 Mar 26:2676591211003874. Epub 2021 Mar 26.

Department of Pulmonary, Critical Care and Sleep Medicine, Northwell Health, Long Island Jewish Medical Center, New Hyde Park, NY, USA.

Introduction: Point-of-care ultrasound (POCUS) is widely utilized to make timely decisions regarding patient care. This approach allowed us to diagnose the cause of acutely rising transaminases in a patient in severe ARDS secondary to influenza pneumonia requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO).

Case Report: A 36-year-old female presented with acute hypoxemic respiratory failure secondary to influenza A infection. Read More

AJR Am J Roentgenol 2021 05 24;216(5):W16. Epub 2021 Mar 24.

University of Minnesota Twin Cities, Minneapolis, MN.

J Clin Exp Hepatol 2021 Mar-Apr;11(2):181-187. Epub 2020 Aug 15.

Institute of Digestive Health & Liver Diseases, Mercy Medical Center, Baltimore, MD, USA.

Objective: The Budd-Chiari Syndrome (BCS) is a rare disorder characterized by hepatic venous outflow obstruction. The primary objectives of our study were to assess temporal trends in the prevalence of BCS among hospitalized patients in the United States using the National Inpatient Sample (NIS) database and to evaluate demographics, risk factors, and common presentation of BCS.

Methods: Data were extracted from the NIS to identify patients >18 years of age using all listed diagnosis of BCS from 1998 to 2017 and analyzed. Read More

Indian J Gastroenterol 2021 Mar 20. Epub 2021 Mar 20.

Shiraz Transplant Research Center, Shiraz University of Medical sciences, Shiraz, Islamic Republic of Iran.

Background/purpose: Budd-Chiari syndrome (BCS) is a rare, life-threatening disease characterized by hepatic venous outflow obstruction. Liver transplantation (LT) is widely accepted as an effective therapeutic measure for irreversible liver failure due to BCS. There is debate on differences in the post LT course and complications in patients with BCS as compared to non-Budd-Chiari (NBC) patients. Read More

Vasc Endovascular Surg 2021 Mar 19:15385744211002026. Epub 2021 Mar 19.

Division of Vascular and Interventional Radiology, Department of Radiology, University of Minneapolis, MN, USA.

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails. Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation. Read More

Res Pract Thromb Haemost 2021 Feb 28;5(2):265-277. Epub 2021 Jan 28.

Department of Medicine and Surgery University of Insubria Varese Italy.

Direct oral anticoagulants (DOACs) are currently the preferred oral anticoagulant treatment for most of the patients with deep vein thrombosis of the lower extremities and/or pulmonary embolism. DOACs have several advantages over vitamin K antagonists, such as availability of fixed dosages, fewer drug interactions, faster onset of action, shorter half-life, and lower risk of major and intracranial bleeding. Although the evidence on the use of DOACs in patients with unusual-site venous thromboembolism (VTE) is limited to a few, small randomized controlled trials, these drugs are increasingly used in clinical practice, and several observational cohort studies have been published recently. Read More

AJR Am J Roentgenol 2021 05 17;216(5):W15. Epub 2021 Mar 17.

All India Institute of Medical Sciences, New Delhi, India.

Acad Radiol 2021 Mar 2. Epub 2021 Mar 2.

Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China. Electronic address:

Rationale And Objectives: To investigate the clinical relevance of liver stiffness (LS) in evaluating liver function properties in patients with Budd-Chiari syndrome (BCS) with different severities and LS variation before and after endovascular intervention.

Materials And Methods: Between December 2016 and March 2019, patients with a diagnosis of BCS were considered for enrollment consecutively in our study. Liver function of these patients was classified according to Child-Pugh grading standard before treatment. Read More

Gastroenterol Hepatol 2021 Mar 1. Epub 2021 Mar 1.

School of Medicine, Nankai University, No.94 Weijin Road, Nankai District, Tianjin, PR, China; Department of Interventional Radiology, Chinese PLA General Hospital, 28 Fu-xing Rd, Beijing 100853, PR, China. Electronic address:

Purpose: The aim of this study was to perform a systematic review and meta-analysis to assess the safety and efficacy of interventional treatment for Budd-Chiari syndrome (BCS) complicated by Inferior Vena Cava thrombosis (IVCT) patients.

Methods: We evaluated the published studies on interventional treatment for BCS complicated by IVCT. Meta-analysis was used to calculate the combined effect size and their 95% confidence intervals (CI) based on random effect. Read More

Kaohsiung J Med Sci 2021 Mar 2. Epub 2021 Mar 2.

Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.

Vascular liver disease (VLD) presents special challenges in the diagnosis, surveillance, and treatment of hepatocellular carcinoma (HCC). HCC arising in the setting of vascular liver disease is often thought to be due to elevated hepatic arterial blood flow, rather than progressive fibrosis from chronic inflammation as with other chronic liver conditions such as viral hepatitis, autoimmune, and metabolic liver diseases. Vascular alteration inherent in VLD often impedes HCC non-invasive diagnosis and loco-regional treatment that depend on vascular properties found in typical liver environment. Read More

Abdom Radiol (NY) 2021 Feb 25. Epub 2021 Feb 25.

Department of Radiology, Nanjing Medical University, Nanjing, Jiangsu, China.

Objective: To evaluate the clinical efficacy and long-term outcomes associated with the treatment of hepatic vein (HV)-type Budd-Chiari syndrome (BCS) via accessory HV (AHV) recanalization.

Methods: In total, 26 HV-type BCS patients underwent AHV recanalization between July 2014 and December 2019 at our hospital, while 73 HV-type BCS patients without compensatory AHV underwent main HV (MHV) recanalization and served as controls in the present study. Short- and long-term clinical outcomes were compared. Read More

Br J Radiol 2021 Apr 17;94(1120):20201157. Epub 2021 Feb 17.

Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

Objective: Comparing the efficacy, safety and outcome of percutaneous intrervention for Budd-Chiari Syndrome (BCS) patients with bilirubin less than 3 and 3-6 mg dl.

Methods And Materials: 188 BCS patients having serum bilirubin ≤6 mg dl and underwent percutaneous interventions were divided into two groups based on bilirubin level: 151 patients having bilirubin <3 mg dl were included in Group 1; and 37 patients having bilirubin 3-6 mg dl were included in Group 2. Both group were compare for technical success (successful recanalization of hepatic venous stenosis or creation of portocaval shunt with post-procedure gradient ≤5 mm of Hg), Safety (procedure-related mortality/morbidity or patient required transplantation) and outcome (resolution of clinical symptoms and survival). Read More

World J Hepatol 2021 Jan;13(1):151-161

Department of Gastroenterology, Abdominal Organs Transplantation Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP), Sao Paulo 05403900, SP, Brazil.

Background: Budd-Chiari syndrome (BCS) is a challenging indication for liver transplantation (LT) due to a combination of massive liver, increased bleeding, retroperitoneal fibrosis and frequently presents with stenosis of the inferior vena cava (IVC). Occasionally, it may be totally thrombosed, increasing the complexity of the procedure, as it should also be resected. The challenge is even greater when performing living-donor LT as the graft does not contain the retrohepatic IVC; thus, it may be necessary to reconstruct it. Read More

Int J Surg 2021 Mar 9;87:105892. Epub 2021 Feb 9.

Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar LohiaHospital, New Delhi, Pin-110001, India.

Am J Emerg Med 2021 Feb 1. Epub 2021 Feb 1.

Division of Emergency Medicine, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, Ribeirão Preto, SP, Brazil. Electronic address:

We described a case report of a 50 years-old-woman admitted to the emergency department with abdominal pain associated with febrile hepatosplenomegaly with the final diagnosis of suprahepatic vein thrombosis secondary to COVID-19. Initially, this patient stayed out of a private room because of this atypical presentation and caused a COVID-19 outbreak in the emergency department. Read More

J Gastrointest Surg 2021 Feb 9. Epub 2021 Feb 9.

Department of Internal Medicine (Gastroenterology), Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Background: Living donor liver transplantation may complement cadaveric transplantation in acute liver failure (ALF) patients.

Methods: Between 2008 and 2017, 89 patients were treated for ALF; 15 patients (17%) recovered with intensive care treatment; 31 (35%) died without transplant. The records of the remaining 43 patients (median (range) age: 14 (1-62)) who underwent transplantation were evaluated. Read More

GE Port J Gastroenterol 2020 Dec 27;28(1):62-66. Epub 2020 May 27.

Serviço de Cuidados Intensivos, Centro Hospitalar Universitário do Porto, Porto, Portugal.

Acute liver failure (ALF) is a rare entity, particularly in the context of Budd-Chiari syndrome (BCS). BCS is an uncommon disorder with multiple risk factors, most commonly myeloproliferative disorders. In BCS, active search and exclusion of underlying malignancy is mandatory, particularly in the context of ALF, as it may contraindicate liver transplantation (LT). Read More

GE Port J Gastroenterol 2020 Dec 9;28(1):5-12. Epub 2020 Jun 9.

Interventional Radiology Unit, Curry Cabral Hospital, Centro Hospitalar Universitário de Lisboa Central (CHULC), Lisbon, Portugal.

Background And Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is used for decompressing clinically significant portal hypertension. The aims of this study were to evaluate clinical outcomes and adverse events associated with this procedure.

Methods: Retrospective single-center study including 78 patients submitted to TIPS placement between January 2015 and November 2018. Read More

Cureus 2021 Jan 7;13(1):e12554. Epub 2021 Jan 7.

Internal Medicine, Medical University of Warsaw, Warsaw, POL.

Coronavirus Disease 2019 (COVID-19) predominantly involves the respiratory system and shows a wide range of severity. There is a growing body of evidence about the occurrence of thromboembolic events in COVID-19. Case Report: We report the case of a 48-year-old female patient who presented with sudden-onset abdominal pain. Read More

J Vasc Surg Venous Lymphat Disord 2021 Jan 30. Epub 2021 Jan 30.

Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Objective: We compared the long-term outcomes of small and large diameter balloon angioplasty for Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) involvement in a retrospective cohort study.

Methods: Of 119 patients with BCS and IVC involvement, 23 had undergone small diameter balloon angioplasty (diameter, 14-20 mm; group A) and 96 had undergone large diameter balloon angioplasty (diameter, 24-30 mm; group B). The patients were considered cured clinically if the IVC was patent with no symptom or signs evident. Read More

Clin Biomech (Bristol, Avon) 2021 Feb 28;82:105256. Epub 2020 Dec 28.

China University of Mining and Technology, No.1, Daxue Road, Xuzhou, Jiangsu, China.

Background: This study aimed to adopt computational fluid dynamics to simulate the blood flow dynamics in inferior vena cava stenosis based on time-dependent patient-specific models of Budd-Chiari syndrome as well as a normal model. It could offer valuable references for a retrospective insight into the underlying mechanisms of Budd-Chiari syndrome pathogenesis as well as more accurate evaluation of postoperative efficacy.

Methods: Three-dimensional inferior vena cava models of Budd-Chiari syndrome patient-specific (preoperative and postoperative) and normal morphology model were reconstructed as per magnetic resonance images using Simpleware. Read More

Ann Surg 2021 04;273(4):e157-e158

Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

JGH Open 2021 Jan 30;5(1):20-27. Epub 2020 Oct 30.

Department of Pediatrics KPC Medical College Kolkata India.

Background And Aim: Limited data exist regarding the etiological spectrum of the subset of chronic liver diseases (CLDs) diagnosed in noncirrhotic states in children. Our primary objective was to study the clinicoetiological profile of CLDs detected in noncirrhotic stages in children younger than 12 years of age. The secondary objective was to find the hepatic histological correlation of provisional diagnosis by different ranks of doctors. Read More