Journal article
Portal vein obstruction after liver transplantation in children treated by simultaneous minilaparotomy and transhepatic approaches: initial experience
Pediatric transplantation, Vol.15(1), pp.47-52
02/2011
DOI: 10.1111/j.1399-3046.2010.01350.x
PMID: 21241438
Abstract
Portal vein thrombosis is a complication that occurs anytime after liver transplantation and can compromise the patient and graft survival. We describe a combined technique for PV recanalization in cases of PV obstruction after liver transplantation. Four children (1%), of 367 subjected to liver transplantation from June 1991 to December 2008, underwent PV recanalization through a combined approach (transhepatic and minilaparotomy). All children received left lateral hepatic segments, developed Portal vein thrombosis (n=3) and stenosis (n=1), and presented with symptoms of portal hypertension after transplantation. PV recanalization was tried by transhepatic retrograde access, and a minilaparotomy was performed when percutaneous recanalization was unsuccessful. Three patients underwent a successful portal recanalization and stent placement with the combined technique. In one patient, the recanalization was unsuccessful because of an extensive portomesenteric thrombosis. The other three children had the portal flow reestablished and followed with Doppler US studies. They received oral anticoagulation for three consecutive months after the procedure and the clinical symptoms subsided. In case of PV obstruction, the combined approach is technically feasible with good clinical and hemodynamic results. It' is a minimally invasive procedure and can be tried to avoid or delay surgical treatment or retransplantation.
Details
- Title: Subtitle
- Portal vein obstruction after liver transplantation in children treated by simultaneous minilaparotomy and transhepatic approaches: initial experience
- Creators
- Francisco C Carnevale - Hospital Sírio-LibanêsAline C B SantosJoão Seda-NetoCharles E ZurstrassenAirton M MoreiraEduardo CaroneAntonio S Z MarcelinoGilda PortaRenata PuglieseIrene MiuraVera D BaggioTeresa GuimarãesGiovanni G CerriPaulo Chapchap
- Resource Type
- Journal article
- Publication Details
- Pediatric transplantation, Vol.15(1), pp.47-52
- DOI
- 10.1111/j.1399-3046.2010.01350.x
- PMID
- 21241438
- ISSN
- 1397-3142
- eISSN
- 1399-3046
- Language
- English
- Date published
- 02/2011
- Academic Unit
- Radiology
- Record Identifier
- 9984697618202771
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