Hepatic venous outflow obstruction (HVOO) is a rare but life-threatening complication after liver transplantation. This article reports a 71-year-old male patient who developed localized stenosis of the infrahepatic inferior vena cava after piggyback liver transplantation for primary liver cancer. The patient experienced ascites and bilateral lower limb edema postoperatively, which did not improve significantly with diuretic therapy and peritoneal drainage. After being diagnosed by digital subtraction angiography, the patient underwent vascular stent implantation on the 105th day after surgery, and the symptoms were significantly alleviated. This article discusses the specific indications and timing for vascular stent placement in the management of HVOO, providing a reference for optimizing the treatment strategy of HVOO.

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