Risk factors for post-operative portal vein stenosis in pediatric liver transplantation: a single center case-control study
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In brief
In brief
This case-control study identifies cryopreserved vein grafts and young donor age as independent risk factors for portal vein stenosis following pediatric liver transplantation. Among 332 patients, cryopreserved grafts showed 55% stenosis rates versus 0% with fresh grafts, highlighting critical technical considerations in pediatric vascular reconstruction.
- Portal vein stenosis occurs in 10.5% of pediatric liver transplant recipients, with incidence varying by reconstruction technique.
- Cryopreserved vein grafts have 55% PVS rate versus 0% with fresh iliac vein grafts—avoid cryopreserved grafts when possible.
- Liver donors under 12 years old carry 18.8% PVS risk, nearly double the overall rate—an independent risk factor.
- Fresh vein graft interposition is superior to cryopreserved grafts for portal vein reconstruction in pediatric transplantation.
Written by the GCMD Library team from the article.
Abstract
Purpose
The incidence of post-transplant poral vein stenosis (PVS) is higher in pediatric liver transplantation, probably resulting from various portal vein (PV) reconstruction methods or other factors.
Methods
332 patients less than 12 years old when receiving liver transplantation (LT) were enrolled in this research. Portal vein reconstruction methods include anastomosis to the left side of the recipient PV trunk (type 1, n = 170), to the recipient left and right PV branch patch (type 2, n = 79), using vein graft interposition (type 3, n = 32), or end-to-end PV anastomosis (type 4, n = 50). The incidence of PVS was analyzed in terms to different PV reconstruction methods and other possible risk factors.
Results
PVS occurred in 35 (10.5%) patients. Of the 32 patients using vein graft, 20 patients received a cryopreserved vein graft, 11 (55%) developed PVS, while the remaining 12 patients received a fresh iliac vein for PV interposition and none of them developed PVS. 9 patients whose liver donor was under 12 years old developed PVS, with an incidence of 18.8%.
Conclusion
Cryopreserved vein graft interposition and a liver donor under 12 are independent risk factors for PVS in pediatric LT.