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CardioVascular and Interventional Radiology

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Open Access 01-01-2018 | Clinical Investigation

Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme

Authors: Ravi Patel, Jeevan Mahaveer, Nasim Tahir, Sanjay Rajwal, Patricia McClean, Jai V. Patel

Published in: CardioVascular and Interventional Radiology | Issue 1/2018

Abstract

Introduction

Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution.

Materials and Methods

227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention. Retrospective clinical and procedural outcome data on these 21 patients were collected.

Results

21 patients, with median age 1.7 years (range 0.4–16.2), underwent 42 procedures with PTA with or without stenting. 36 procedures were for PV stenosis and 6 for PV thrombosis. Treatment was with primary PTA, with stenting reserved for suboptimal PTA result or restenosis within 3 months. 28 procedures were performed with PTA and 13 with stenting. Technical success (>50% reduction in mean pressure gradient, absolute pressure gradient ≤4 mmHg or venographic stenosis <30%) was achieved in 41 procedures. Failure to recanalise a thrombosed PV occurred in 1 procedure. There were no major procedural complications. Patients were followed-up with serial Doppler ultrasound surveillance. Kaplan–Meier estimated median primary patency was 9.9 months, with primary-assisted patency of 95% after median follow-up of 45.5 months (range 11.1–171.6).

Conclusion

With regular surveillance, excellent patency rates can be achieved following percutaneous intervention for PVC post-paediatric liver transplantation.

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Title: Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme
Authors: Ravi Patel
Jeevan Mahaveer
Nasim Tahir
Sanjay Rajwal
Patricia McClean
Jai V. Patel
Publication date: 01-01-2018
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 1/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-017-1792-0

At a glance: The STEP trials

Springer Medicine

Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme

Abstract

Introduction

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and Methods

Results

Conclusion

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