LIVER-TRANSPLANTATION IN PATIENTS WITH BUDD-CHIARI SYNDROME

Patients with Budd-Chiari syndrome (obstruction of the hepatic veins) and associated hepatic insufficiency may be candidates for orthotopic liver transplantation (OLT). In our series of 405 OLT patients, 3 were transplanted due to Budd-Chiari syndrome (0.7 %). The indication for liver transplantation in these patients was severe hepatic insufficien cy (chronic in two and acute in the third one). Morphologic study of t he obstructions revealed apparently different causes, including thromb i, membranous webs in hepatic veins, and hydatid cyst compression. The surgical technique employed in these transplantations was similar to that for other etiologies. Due to its implications for the future cour se of OLT, it is important to determine the exact etiology of Budd-Chi ari syndrome in the pretransplant period and to treat the patients wit h early and long-term anticoagulant therapy to avoid syndrome recurren ce.