Embolization of a Hepatic Arterio-Portal Venous Fistula to Treat Portal Hypertension in a Liver Transplant Recipient

Hepatic arterio-portal venous fistula (HAPVF) is a rare, abnormal connection between the hepatic artery and portal vein. HAPVFs are usually caused by trauma or hepatobiliary instrumentation. Fistulas can expand and produce symptoms of severe portal hypertension. The decision to embolize should be ba...

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Bibliographic Details
Published in:Transplantology (Basel, Switzerland) Switzerland), 2024-06, Vol.5 (2), p.110-115
Main Authors: Yoon, Ji Ae, Chao, Cherng, Lominadze, Zurabi
Format: Article
Language:English
Subjects:
arteriovenous fistula
Ascites
Biopsy
case report
Embolization
Enzymes
Fistula
Hepatitis
Hypertension
Iatrogenesis
Liver cirrhosis
Liver transplants
portal hypertension
Standard of care
Thrombosis
Veins & arteries
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Summary:Hepatic arterio-portal venous fistula (HAPVF) is a rare, abnormal connection between the hepatic artery and portal vein. HAPVFs are usually caused by trauma or hepatobiliary instrumentation. Fistulas can expand and produce symptoms of severe portal hypertension. The decision to embolize should be based on fistula location, size, and symptoms. We report a case of HAPVF in a liver transplant recipient presenting with worsening ascites and variceal hemorrhage after several prior liver biopsies. Given the extensive nature of the fistula and hepatic decompensation, the HAPVF was successfully embolized, resulting in clinical improvement and obviating the need for re-transplantation.
ISSN:2673-3943
2673-3943
DOI:10.3390/transplantology5020011