Percutaneous Transhepatic Balloon Dilation of Portal Venous Stenosis in Patients with Living Donor Liver Transplantation

Abstract

Percutaneous transhepatic balloon dilation seems to be an effective method for treatment of portal venous stenosis after living donor liver transplantation.

Vascular complications following liver transplantation: A literature review of advances in 2015

“…Finally, regarding the recurrence rate, this ranges between 0%-100%. Shibata et al [128] (2005) reported the most important series in the literature where the recurrence rate was 28.6%. Some authors recommend the use of anticoagulant therapy for the prevention of recurrent PVT [134] .…”

“…Some authors consider the pressure gradient between the pre and poststenosis site. Wei et al [126] (2009) considered a gradient of > 5 mmHg to initiate treatment, while Shibata et al [128] (2005) used a significant gradient of > 3 mmHg. Other authors did not measure gradients if the stenosis was noted to be greater than 75% of the main portal vein diameter.…”

“…Regarding PVS management, it is possible to use the transhepatic access or transjugular access [133] , but most authors choose a transhepatic approach, usually from the right side. Shibata et al [128] (2005) reported that a single balloon dilatation was sufficient to maintain patency in 77.7% of patients, with a mean followup of 24.8 mo. In some series, stent placement associated with PTA was used to prevent recurrence.…”

Successful Treatment by Balloon Angioplasty Under Portography for Late-Onset Stenosis of Portal Vein After Cadaveric Liver Transplantation

“…8,9 On the long-term results of this procedure, a recent study reported the patency of portal vein after balloon angioplasty for portal stenosis was 71.4% with a mean follow-up of 24.4 months. 10 For a residual significant stenosis or a recurrent stenosis within a few months after balloon angioplasty, the metallic stent placement should be considered. 11,12 However, there is a retransplantation case report about graft failure caused by portal thrombus after the placement of a portal vein stent for portal stenosis.…”

The perspective of liver transplantation for cholangiocarcinoma

“…This finding is in accordance with previous reports on DDLT in adults and in children and on LDLT. [28][29][30][31] It shows that angioplasty is also effective after neoadjuvant radiotherapy, with the reservation that mostly multiple interventions were required and that the future course is less predictable in view of the progressive nature of late portal vein stenoses. Our own experience in patients without radiation is also favorable, although we favor the transjugular intrahepatic technique of portal vein angioplasty also for extrahepatic stenoses because it is likely to reduce the risk of intra-abdominal bleeding in comparison with the percutaneous transhepatic approach.…”