Recanalization of portal vein thrombosis after pediatric liver transplantation: Efficacy and safety of the transsplenic access.

Autor: Cavalcante ACBS; Interventional Radiology, A. C. Camargo Cancer Center, São Paulo, Brazil., Carnevale FC; Interventional Radiology, Hospital Sírio-Libanês, São Paulo, Brazil., Zurstrassen CE; Interventional Radiology, A. C. Camargo Cancer Center, São Paulo, Brazil., Pugliese RPS; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Moreira AM; Interventional Radiology, Hospital Sírio-Libanês, São Paulo, Brazil., Assis AM; Interventional Radiology, Hospital Sírio-Libanês, São Paulo, Brazil., Matushita Junior JPK; Interventional Radiology, A. C. Camargo Cancer Center, São Paulo, Brazil., Danesi VLB; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Benavides MAR; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Hirschfeld APM; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Borges CBV; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Miura IK; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Porta G; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., Fonseca EA; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil., ChapChap P; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil., Neto JS; Hepatology and Liver Transplantation, Hospital Sírio-Libanês, São Paulo, Brazil.; Hepatology and Liver Transplantation, A. C. Camargo Cancer Center, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2024 Feb; Vol. 28 (1), pp. e14537. Date of Electronic Publication: 2023 Aug 07.
DOI: 10.1111/petr.14537
Abstrakt: Background: Endovascular management of portal vein thrombosis (PVT) is challenging. Transsplenic access (TSA) is growing as an access option to the portal system but with higher rates of bleeding complications. The aim of this article is to evaluate the efficacy and safety of transsplenic portal vein recanalization (PVR) using a metallic stent after pediatric liver transplantation.
Materials and Methods: This is a retrospective review of 15 patients with chronic PVT who underwent PVR via TSA between February 2016 and December 2020. Two children who had undergone catheterization of a mesenteric vein tributary by minilaparotomy were excluded from the patency analysis but included in the splenic access analysis. The technical and clinical success of PVR and complications related to the procedure via TSA were evaluated.
Results: Thirteen children with PVT were treated primarily using the TSA. The mean age was 4.1 years (range, 1.5-13.7 years), and the most common clinical presentation was hypersplenism (60%). Technically successful PVR was performed in 11/13 (84.6%) children, and clinical success was achieved in 9/11 (81.8%) children. No major complications were observed, and one child presented moderate pain in the TSA (from a total of 17 TSA). The median follow-up was 48.2 months. The median primary patency was 9.9 months. Primary patency in the first 4 years was 75%, and primary assisted patency was 100% in the follow-up period.
Conclusions: Transsplenic PVR is a safe and effective method for the treatment of PVT after pediatric liver transplantation.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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