Transileocolic venous balloon dilatation for the management of primary and recurrent portal venous stenosis after living donor liver transplantation in children

Hotta, Ryo; Hoshino, Ken; Nakatsuka, Seishi; Nakao, Shioko; Okamura, Jun; Yamada, Yasuaki; Kono, Koji; Fuchimoto, Yasushi; Obara, Hideaki; Kawa, Shigeyuki; Tanabe, Minoru; Morikawa, Yasuhide; Hashimoto, Subaru; Kitajima, Masaki

doi:10.1007/s00383-007-1974-y

Cited by 14 publications

(35 citation statements)

References 23 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, the feasibility of the intraoperative segment 4 PV stump stenting approach has been reported . The reported success rate of interventional radiology for PV complications range from 60.7% to 100% . However, when stent placement for PVS/PVT in small infants is needed, a potential problem that arises as the child grows is that a stented PV may not be able to adjust to size, and more longterm follow‐up data is needed to confirm safety.…”

Section: Discussionmentioning

confidence: 99%

“…(36,38,40) Interventional radiology (balloon angioplasty, stent replacement) is used to treat, and recanalization with stent placement is limited to cases that need repeat balloon dilatation for PVS recurrence. (36,38,40) Access for PV angioplasty and stent placement is typically via a percutaneous transhepatic approach, (40) but a percutaneous transsplenic (41) or transileocolic approach by minilaparotomy (42) has been described.…”

Section: Original Article | 1567mentioning

confidence: 99%

“…(43) The reported success rate of interventional radiology for PV complications range from 60.7% to 100%. (37,38,42) However, when stent placement for PVS/PVT in small infants is needed, a potential problem that arises as the child grows is that a stented PV may not be able to adjust to size, and more longterm follow-up data is needed to confirm safety. An alternative way to re-establish PV flow after LT is by a meso-Rex shunt, with the use of the left internal jugular vein as a graft being reported to have 100% patency in the long term.…”

Section: Original Article | 1567mentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of Liver Transplantation in Small Infants

et al. 2019

View full text Add to dashboard Cite

Liver transplantation (LT) for small infants remains challenging because of the demands related to graft selection, surgical technique, and perioperative management. The aim of this study was to evaluate the short‐term and longterm outcomes of LT regarding vascular/biliary complications, renal function, growth, and patient/graft survival in infants ≤3 months compared with those of an age between >3 and 6 months at a single transplant center. A total of 64 infants ≤6 months underwent LT and were divided into 2 groups according to age at LT: those of age ≤3 months (range, 6‐118 days; XS group, n = 37) and those of age >3 to ≤6 months (range, 124‐179 days; S group, n = 27) between 1989 and 2014. Acute liver failure was the main indication for LT in the XS group (n = 31, 84%) versus S (n = 7, 26%). The overall incidence of hepatic artery thrombosis and portal vein thrombosis/stricture were 5.4% and 10.8% in the XS group and 7.4% and 11.1% in the S group, respectively (not significant). The overall incidence of biliary stricture and leakage were 5.4% and 2.7% in the XS group and 3.7% and 3.7% in the S group, respectively (not significant). There was no significant difference between the 2 groups in terms of renal function. No significant difference was found between the 2 groups for each year after LT in terms of height and weight z score. The 1‐, 5‐, and 10‐year patient survival rates were 70.3%, 70.3%, and 70.3% in the XS group compared with 92.6%, 88.9%, and 88.9% in the S group, respectively (not significant). In conclusion, LT for smaller infants has acceptable outcomes despite the challenges of surgical technique, including vascular reconstruction and graft preparation, and perioperative management.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Original Article | 1567mentioning

confidence: 99%

Section: Original Article | 1567mentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Liver Transplantation in Small Infants

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Angioplasty provides an option for those with PHT contraindicating surgery, although it has been successfully utilised in the absence of PHT when surgery is expected to be difficult 3 7. Approaches for angioplasty include percutaneous transhepatic, transileocolic and transjugular intrahepatic access to the portal vein 8 9. While certain scenarios preclude a technique, the three have shown equivalent efficacy 8 9.…”

Section: Discussionmentioning

confidence: 99%

“…Approaches for angioplasty include percutaneous transhepatic, transileocolic and transjugular intrahepatic access to the portal vein 8 9. While certain scenarios preclude a technique, the three have shown equivalent efficacy 8 9. Balloon dilation alone commonly results in recurrent stenosis; however, use of a metallic stent increases risk for thrombosis 1.…”

Section: Discussionmentioning

confidence: 99%

Jejunal varices: an unconsidered cause of recurrent gastrointestinal haemorrhage

Heiberger

Mehta²,

Yim

2019

BMJ Case Rep

View full text Add to dashboard Cite

A 78-year-old woman presented with melaenic stool and severe anaemia 4 years after a pancreaticoduodenectomy for adenocarcinoma of the pancreas. Initial workup revealed haemorrhage from the choledochojejunostomy site. Despite multiple endoscopic clips to the region, bleeding reoccurred multiple times over a period of several months. Due to ongoing haemorrhage, her case was urgently presented at the hospital’s multidisciplinary hepatobiliary conference. The contrast-enhanced abdominal CT revealed severe stenosis of the extrahepatic portal vein and large afferent jejunal varices at the choledochojejunostomy, suspected as the cause of her persistent bleed. The recommendation was a percutaneous transhepatic approach for stenting of the portal vein stenosis that resulted in rapid decompression of the jejunal varices and control of her haemorrhage.

show abstract

Long‐term outcome of primary percutaneous stent angioplasty for pediatric posttransplantation portal vein stenosis

Bukova

Funken

Pfister

et al. 2022

Liver Transplantation

View full text Add to dashboard Cite

This study aims to evaluate the long-term efficacy and reintervention rate after primary percutaneous portal vein stent angioplasty for portal vein stenosis (PVS) in pediatric liver transplantation (LT) recipients. From 2004 to 2020, a total of 470 pediatric LTs were performed in our center. All cases were screened for interventional PVS treatment and analyzed retrospectively. We identified 44 patients with 46 percutaneous angioplasties for posttransplantation PVS. The median interval from LT to percutaneous catheter intervention was 5 months (16 days-104 months) with a median follow-up (f/u) period after catheter intervention of 5.7 years (2-156 months). In 40 patients, an endovascular stent was placed as primary (n = 38) or secondary (n = 2) intervention. The median age at stent placement was 23 (6-179) months with a median weight of 10 kg (6-46 kg).Technical success and relief of PVS were achieved in all patients irrespective of age or weight. Adverse events occurred peri-interventionally in two patients and were resolved with standard care. All primary portal vein (PV) stents remained patent until the end of f/u. Reinterventions have been successfully performed in 10 patients for suspected or proven restenosis, resulting in a primary patency rate of 75% and an assisted patency rate of 25%. The median time to reintervention was 6.2 years (range 1-10 years). The need for reintervention was independent of age or weight at both transplantation and initial angioplasty as well as of additional risk factors due to portal hypertension. Percutaneous transhepatic PV stent angioplasty in children is safe and effective in all age groups, with excellent long-term patency. Primary stent angioplasty should be considered as first-line treatment for PVS after pediatric LT.

show abstract

Transileocolic venous balloon dilatation for the management of primary and recurrent portal venous stenosis after living donor liver transplantation in children

Cited by 14 publications

References 23 publications

Outcomes of Liver Transplantation in Small Infants

Outcomes of Liver Transplantation in Small Infants

Jejunal varices: an unconsidered cause of recurrent gastrointestinal haemorrhage

Long‐term outcome of primary percutaneous stent angioplasty for pediatric posttransplantation portal vein stenosis

Contact Info

Product

Resources

About