Format

Send to

Choose Destination
J Vasc Interv Radiol. 2014 Sep;25(9):1406-12. doi: 10.1016/j.jvir.2014.03.034. Epub 2014 May 20.

Long-term outcome of percutaneous transhepatic balloon angioplasty for portal vein stenosis after pediatric living donor liver transplantation: a single institute's experience.

Author information

1
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
2
Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. Electronic address: ksj@kuhp.kyoto-u.ac.jp.
3
Department of Surgery, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.

Abstract

PURPOSE:

To evaluate retrospectively the long-term outcomes of percutaneous transhepatic balloon angioplasty performed for portal vein stenosis (PVS) after pediatric living donor liver transplantation (LDLT).

MATERIALS AND METHODS:

Between October 1997 and December 2013, of 527 pediatric patients (age < 18 y) who underwent LDLT in a single institution, 43 patients (19 boys, 24 girls; mean age, 4.1 y ± 4.1) were confirmed to have PVS at direct portography with or without manometry and underwent percutaneous interventions, including balloon angioplasty with or without stent placement. Technical success, clinical success, laboratory findings, manometry findings, patency rates, and major complications were evaluated. Follow-up periods after initial balloon angioplasty ranged from 5-169 months (mean, 119 mo).

RESULTS:

Technical success was achieved in 65 of 66 sessions (98.5%) and in 42 of 43 patients (97.7%), and clinical success was achieved in 37 of 43 patients (86.0%). Platelet counts improved significantly. Of 32 patients undergoing manometry, 19 showed significant improvement of pressure gradient across the stenosis after percutaneous transhepatic balloon angioplasty. At 1, 3, 5, and 10 years after balloon angioplasty, the rates of primary patency were 83%, 78%, 76%, and 70%, and the rates of primary-assisted patency were 100%, 100%, 100%, and 96%. Two major complications subsequent to balloon angioplasty were noted: severe asthma attack and portal vein thrombosis.

CONCLUSIONS:

Percutaneous transhepatic balloon angioplasty is a safe and effective treatment with long-term patency for PVS after pediatric LDLT.

PMID:
24854391
DOI:
10.1016/j.jvir.2014.03.034
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center