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Beaubien-Souligny W, Pépin MN, Legault L, et al. Acute Kidney Injury Due to Inferior Vena Cava Stenosis After Liver Transplantation: A Case Report About the Importance of Hepatic Vein Doppler Ultrasound and Clinical Assessment. Can J Kidney Health Dis. 2018;5:2054358118801012doi: 10.1177/2054358118801012.
Beaubien-Souligny, W., Pépin, M. N., Legault, L., Cailhier, J. F., Éthier, J., Bouchard, L., Willems, B., & Denault, A. Y. (2018). Acute Kidney Injury Due to Inferior Vena Cava Stenosis After Liver Transplantation: A Case Report About the Importance of Hepatic Vein Doppler Ultrasound and Clinical Assessment. Canadian journal of kidney health and disease, 52054358118801012. https://doi.org/10.1177/2054358118801012
Beaubien-Souligny, William, et al. "Acute Kidney Injury Due to Inferior Vena Cava Stenosis After Liver Transplantation: A Case Report About the Importance of Hepatic Vein Doppler Ultrasound and Clinical Assessment." Canadian journal of kidney health and disease vol. 5 (2018): 2054358118801012. doi: https://doi.org/10.1177/2054358118801012
Beaubien-Souligny W, Pépin MN, Legault L, Cailhier JF, Éthier J, Bouchard L, Willems B, Denault AY. Acute Kidney Injury Due to Inferior Vena Cava Stenosis After Liver Transplantation: A Case Report About the Importance of Hepatic Vein Doppler Ultrasound and Clinical Assessment. Can J Kidney Health Dis. 2018 Oct 03;5:2054358118801012. doi: 10.1177/2054358118801012. eCollection 2018. PMID: 30302268; PMCID: PMC6172939.
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Can J Kidney Health Dis. 2018 Oct 03;5:2054358118801012. doi: 10.1177/2054358118801012. eCollection 2018.

Acute Kidney Injury Due to Inferior Vena Cava Stenosis After Liver Transplantation: A Case Report About the Importance of Hepatic Vein Doppler Ultrasound and Clinical Assessment.

Canadian journal of kidney health and disease

William Beaubien-Souligny, Marie-Noëlle Pépin, Louis Legault, Jean-François Cailhier, Jean Éthier, Louis Bouchard, Bernard Willems, André Y Denault

Affiliations

  1. Division of Nephrology, Centre Hospitalier de l'Université de Montréal, QC, Canada.
  2. Department of Anesthesiology and Intensive care, Centre Hospitalier de l'Université de Montréal, QC, Canada.
  3. Department of Radiology, Centre Hospitalier de l'Université de Montréal, QC, Canada.
  4. Division of Hepatology, Centre Hospitalier de l'Université de Montréal, QC, Canada.
  5. Division of Intensive Care, Centre Hospitalier de l'Université de Montréal, QC, Canada.

PMID: 30302268 PMCID: PMC6172939 DOI: 10.1177/2054358118801012

Abstract

RATIONALE: Acute kidney injury (AKI) is a frequent complication after liver transplantation. In some patients, prompt intervention targeted at a specific etiology is of paramount importance.

PRESENTING CONCERNS OF THE PATIENTS: A 25 years old man with advanced liver cirrhosis caused by sclerosing cholangitis and autoimmune hepatitis underwent orthotopic liver transplantation. One month after surgery, severe AKI developed in conjunction with recurrent ascites and lower extremity edema. Notable clinical findings included a persistently low urinary sodium excretion, a bland urinary sediment, and an abnormally monophasic hepatic vein waveform on Doppler ultrasound.

DIAGNOSES: Inferior vena cava stenosis.

INTERVENTIONS: Angioplasty with stent installation.

OUTCOMES: Rapid improvement of renal function after stent installation.

LESSONS LEARNED: The following case illustrates the importance of integrating clinical cues, ultrasound features, and laboratory findings. The combination of AKI associated with lower extremity edema, abnormal monophasic hepatic vein flow on Doppler ultrasound, and a low urinary sodium excretion after liver transplantation should evoke the possibility of inferior vena cava stenosis as the etiologic factor.

Keywords: Doppler ultrasound; acute kidney injury; hepatic vein Doppler; hepatorenal reflex; liver transplantation; venous congestion

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AYD was a Speak

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