In this study, we analyzed occurrence and recurrence of esophagogastric varices in 84 patients with primary biliary cirrhosis (PBC). Esophagogastric varices were observed in 20 of 84 patients (23.8%) with PBC. Histological study of 18 patients, in whom varices had already existed at diagnosis, revealed that 6 cases (33.3%) were at the Scheuer's stage I or II, and 12 cases (66.7%) were at stage III or IV. The varicescomplicated group was more likely to be associated with female gender, splenomegaly and pruritus than the non-complicated group. Analysis of laboratory and histological findings showed that prothrombin time and platelets were significantly lower and the histological stage was more advanced in the complicated group. Recurrence was found in 6 cases (35.3%) among 17 patlents who were endoscopically treated. Laboratory findings were not significantly different between the recurrence group and the non-recurrence group.
We reconfirmed that esophagogastric varices are observed in patients with PBC at early histological stages. This observation suggests that anatomical differences of collateral circulation surrounding the esophagus or stomach is, in addition to portal venous pressure, important in the development of esophageal varices of PBC.

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In the present communication we describe etiology, treatment and outcome of portal flow abnormality of patients with end-stage liver diseases who underwent living donor liver transplantation (LDLT).
Before LDLT 12% of the patients had various kinds of portal flow abnormality which were successfully corrected by end-to-end anastomosis. After LDLT 12% of the patients showed portal flow disturbance such as stenosis or kinking of portal anastomosis, most of which were attributable to surgical procedures. The surgical complications were successfully treated in all cases. However, 4 patients who developed portal flow disturbance through non-surgical causes died of severe rejection or gastrointestinal bleeding.
Portal flow abnormality both before and after LDLT has been largely overcome by the surgical innovations. However, prognosis is still poor in cases which develop the abnormality due to parenchymal damage caused by rejection.
Careful preoperative evaluation, early diagnosis and appropriate treatment of postoperative complications and strict management of rejection are all essential to achieve successful result in LDLT for portal venous flow abnormality.

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[in Japanese]

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