Table 8.

Caval anastomosis complication highlights

Summary of the clinical characteristics about CAC
The incidence of CAC is not known and is thought to be less than 3%
CAC is represented by stenosis, thrombosis and kinking depending on the type of caval anastomosis (cava resection or PB)
Clinical presentation of CAC ranges from lower limb edema, hepatomegaly, ascites, pleural effusions, Budd-Chiari syndrome, liver and renal failure, and hypotension, leading to allograft loss and even death
The main risk factor is a technical error in the creation of the anastomosis, which leads to kinking stenosis and thrombosis
Modified-PB with the three-hepatic vein seems to offer better outcomes because it has been demonstrated to be an efficient and safe method
Diagnosis tools include DUS, contrast-enhanced CT and cavography
Percutaneous radiological intervention is the method of choice via a transjugular approach or transhepatic approach if the anastomosis cannot be catheterized
It includes angioplasty by balloon dilatation and recurrences should be prevented by stent placement

CAC: Caval anastomosis complication; DUS: Doppler ultrasound; CT: Computed tomography; PB: Piggyback.