Endovascular stent placement for venous complications following pediatric liver transplantation: outcomes and indications
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In brief
In brief
This study evaluates endovascular stent placement for venous complications after pediatric living donor liver transplantation in 282 patients. Stenting proved effective for portal vein complications with sustained patency, but hepatic vein stenting carried high thrombosis risk requiring careful patient selection.
Written by the GCMD Library team from the article.
Abstract
Purpose
Advances in interventional radiology (IVR) treatment have notably improved the prognosis of hepatic vein (HV) and portal vein (PV) complications following pediatric living donor liver transplantation (LDLT); however, graft failure may develop in refractory cases. Although endovascular stent placement is considered for recurrent stenosis, its indications are controversial.
Methods
We enrolled 282 patients who underwent pediatric LDLT in our department from May 2001 to September 2016.
Results
22 (7.8%) HV complications occurred after LDLT. Recurrence was observed in 45.5% of the patients after the initial treatment, and 2 patients (9.1%) underwent endovascular stent placement. The stents were inserted at 8 months and 3.8 years following LDLT, respectively. After stent placement, both patients developed thrombotic obstruction and are currently being considered for re-transplantation. 40 (14.2%) PV complications occurred after LDLT. Recurrence occurred in 27.5% of the patients after the initial treatment, and 4 patients (10.0%) underwent endovascular stent treatment. The stents of all the patients remained patent, with an average patency duration of 41 months.
Conclusion
Endovascular stent placement is an effective treatment for intractable PV complications following pediatric LDLT. However, endovascular stent placement for HV complications should be carefully performed because of the risk of intrastent thrombotic occlusion and the possibility of immunological venous injury.