Tissue expanders – an innovative approach in the management of hepatic venous outflow obstruction after liver transplantation: A case report

Figure 1 Computed tomography. A: Computed tomography (CT) angiography after first transplant procedure showed a lack of opacification in the hepatic arteries; B: CT scan after first transplant showed localized ischemic zones in segment VI; C: Subacute and acute peripheral wedge infarcts of segments VI and VII of the liver graft on follow-up CT scan.

Figure 2 Surgical procedure details. A: The first transplanted graft with visible areas of ischemia due to hepatic artery thrombosis; B: The anastomosis of the donor aorta and celiac trunk as a patch on the recipient’s supraceliac aorta; C: The placement of the tissue expander between the liver and right abdominal wall.

Figure 3 Follow-up computed tomography scan. Ischemic areas in segments VII and IVa of the liver graft were not clinically relevant.

Figure 4 Follow-up magnetic resonance imaging. Optimal position of the tissue expander with patent vessels and no new ischemic lesions.