Long-term outcomes of transmesenteric portal vein recanalization for the treatment of chronic portal vein thrombosis after pediatric liver transplantation

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
A C B S CavalcanteJoão Seda-Neto

Abstract

Portal vein thrombosis (PVT) may occur at any time following liver transplantation. We describe our experience with portal vein recanalization in cases of thrombosis after liver transplantation. Twenty-eight children (5%) out of 566 liver transplant recipients underwent portal vein recanalization using a transmesenteric approach. All children received left hepatic segments, developed PVT, and had symptoms or signs of portal hypertension. Portal vein recanalization was performed via the transmesenteric route in all cases. Twenty-two (78.6%) patients underwent successful recanalization and stent placement. They received oral anticoagulants after the procedure, and clinical symptoms subsided. Symptoms recurred due to portal vein restenosis/thrombosis in seven patients. On an intention-to-treat basis, the success rate of the proposed treatment was 60.7%. Only 17 out of 28 children with posttransplant chronic PVT retained stent patency (primary + assisted) at the end of the study period. In cases of portal vein obstruction, the transmesenteric approach via minilaparotomy is technically feasible with good clinical and hemodynamic results. It is an alternative procedure to reestablish the portal flow to the liver graft that can be per...Continue Reading

References

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Apr 1, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Y-F ChengC-L Chen
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Nov 27, 2014·Pediatric Transplantation·Seyed Kamran Hejazi KenariReza F Saidi

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Citations

Jan 30, 2019·Current Opinion in Organ Transplantation·Priyal Patel, Joseph DiNorcia
Aug 6, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Hidekazu YamamotoNigel Heaton
Mar 20, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Gi Young KoDong Il Gwon
Jan 6, 2021·International Journal of Surgery Case Reports·Tadashi TsukamotoYukio Nishiguchi
Jun 10, 2021·Transplantation Reviews·Bader A AlfaresHubert P J van der Doef

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