A complication associated with the use of neonatal liver in orthotopic liver transplantation.

Background: Neonatal livers have been associated with a higher incidence of vascular complications but are nevertheless used because of donor shortage.

Objective: We report a complication of hepatic venous outflow obstruction because we retained the neonatal retrohepatic cava from the first transplant for retransplantation using a left lateral segment.

Methods: Technical and post-operative complications associated with a small "native" inferior cava and transplantation are described.

Results: Successful treatment with balloon angioplasty resulted in re-establishing the flow in the hepatic venous outflow tract. The child is well 3 years on with stable graft function.

Conclusions: Percutaneous transluminal angioplasty is an effective non-surgical therapy for post liver transplant hepatic venous outflow obstruction. Replacement of the inferior venacava rather than retaining neonatal venacava may be a better option during retransplantation.