Long-term outcomes of transmesenteric portal vein recanalization for the treatment of chronic portal vein thrombosis after pediatric liver transplantation
| Autor: | Joao Seda-Neto, Irene Miura, Eduardo A. Fonseca, Aline Cristine Barbosa Santos Cavalcante, Francisco Cesar Carnevale, Vera B. Danesi, Gilda Porta, Helry Lopes Cândido, Renata Pugliese, Paulo Chapchap, C. B. V. Borges, Airton Mota Moreira, Charles Edouard Zurstrassen, J. P. K. Matushita, A. P. M. Hirschfeld, Marcel Benavides |
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| Rok vydání: | 2017 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty medicine.medical_treatment Hemodynamics 030230 surgery Liver transplantation 03 medical and health sciences 0302 clinical medicine Restenosis Risk Factors medicine Immunology and Allergy Humans Pharmacology (medical) Child Survival rate Retrospective Studies Venous Thrombosis Transplantation business.industry Portal Vein Liver Diseases Graft Survival Infant Retrospective cohort study medicine.disease Prognosis Thrombosis Surgery Portal vein thrombosis Liver Regeneration Liver Transplantation Survival Rate Child Preschool Portal hypertension 030211 gastroenterology & hepatology Female business Follow-Up Studies |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 18(9) |
| ISSN: | 1600-6143 |
| Popis: | 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 performed in selected cases and a therapeutic addition to other treatment strategies currently used to treat chronic PVT. |
| Databáze: | OpenAIRE |
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