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

Ryo Hotta, Ken Hoshino, Seishi Nakatsuka, Shioko Nakao, Jun Okamura, Yohei Yamada, Koji Komori, Yasushi Fuchimoto, Hideaki Obara, Shigeyuki Kawachi, Minoru Tanabe, Yasuhide Morikawa, Subaru Hashimoto, Masaki Kitajima

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12 Citations (Scopus)

Abstract

Portal venous stenosis is relatively a rare complication after liver transplantation in children and it sometimes leads to life threatening event due to gastrointestinal bleeding or graft failure. Recently, balloon dilatation has been widely accepted as a treatment of choice for the management of portal venous stenosis. The purpose of this study was to evaluate the feasibility of transileocolic venous balloon dilatation for the management of primary and recurrent portal venous stenosis after living donor liver transplantation (LDLT) in children. The records of 57 pediatric liver transplants were retrospectively reviewed. Nine patients (15.8%) with portal venous stenosis were identified. Seven symptomatic children with portal venous stenosis underwent balloon dilatation. Two approaches were employed for balloon dilatation; the transileocolic venous approach and the percutaneous transhepatic approach. In patients with recurrent stenosis, careful follow-up was carried out while they were asymptomatic. Twelve balloon dilatations were performed in seven children with primary or recurrent portal venous stenoses. The initial technical success rate was 91.7% (11/12), while 6 out of 12 (50.0%) procedures resulted in recurrent stenosis. Five out of six recurrent stenoses required repeated balloon dilatation. The clinical success rate of balloon dilatation in our study was 85.7% (6/7). Other than recurrent stenosis, two procedure-related complications occurred. In conclusion, transileocolic venous balloon dilatation was a safe and effective procedure for portal venous stenosis after LDLT in children.

Original languageEnglish
Pages (from-to)939-945
Number of pages7
JournalPediatric surgery international
Volume23
Issue number10
DOIs
Publication statusPublished - 2007 Oct 1

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Keywords

  • Balloon dilatation
  • Children
  • Liver transplantation
  • Living donor
  • Portal vein, stenosis or obstruction
  • Transileocolic venous approach

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Hotta, R., Hoshino, K., Nakatsuka, S., Nakao, S., Okamura, J., Yamada, Y., Komori, K., Fuchimoto, Y., Obara, H., Kawachi, S., Tanabe, M., Morikawa, Y., Hashimoto, S., & Kitajima, M. (2007). Transileocolic venous balloon dilatation for the management of primary and recurrent portal venous stenosis after living donor liver transplantation in children. Pediatric surgery international, 23(10), 939-945. https://doi.org/10.1007/s00383-007-1974-y