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Interventional Radiological Treatment of Paediatric Liver Transplantation Complications

JH. Peregrin, J. Kováč, M. Prchlík, P. Heinige, R. Kotanová, J. Froňek, R. Novotný, M. Kočík, L. Janoušek,

. 2020 ; 43 (5) : 765-774. [pub] 20200210

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc20028200

PURPOSE: To assess the efficacy of percutaneous techniques in managing paediatric liver transplantation complications. MATERIAL AND METHODS: We carried out 105 paediatric cadaveric donor liver transplantations at our centre from 2001 to 2018. Percutaneous techniques were used to treat 25 cases involving transplantation complications in 23 patients. Biliary complications were treated in 14 cases (13.3%): 10 patients had bile duct obstruction, and 4 had biliary leaks. Vascular complications were treated in 11 cases (10.5%): 5 hepatic artery (HA) stenoses/occlusions, 2 inferior vena cava (IVC) stenoses, and 1 portal vein (PV) stenosis. Other interventions involved embolisation of the superior mesenteric artery branch to manage gastrointestinal bleeding in 2 patients and embolisation of an arteriobiliary fistula in 1 patient. RESULTS: Biliary: We carried out external-internal drainage and balloon dilatation of stenoses in 12 cases. The external-internal drainage catheter was removed after 6-8 weeks in 7 patients, with the remaining 5 patients with persisting stenosis assigned for retransplantation. We failed to cross anastomotic occlusions in 2 patients before completing the procedures using external drainage; both individuals subsequently underwent retransplantation. Vascular: We performed PTA/stenting of HA stenoses/occlusions in 4 out of 5 patients. After the procedure, all 4 patients showed liver function normalisation. All 3 cases of embolisation were technically and clinically successful. Both IVC and PV stenoses treated with dilatation/stenting were also successful. CONCLUSIONS: Percutaneous techniques used to treat biliary and vascular complications after liver transplantation in paediatric patients are safe and efficient.

Citace poskytuje Crossref.org

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$a PURPOSE: To assess the efficacy of percutaneous techniques in managing paediatric liver transplantation complications. MATERIAL AND METHODS: We carried out 105 paediatric cadaveric donor liver transplantations at our centre from 2001 to 2018. Percutaneous techniques were used to treat 25 cases involving transplantation complications in 23 patients. Biliary complications were treated in 14 cases (13.3%): 10 patients had bile duct obstruction, and 4 had biliary leaks. Vascular complications were treated in 11 cases (10.5%): 5 hepatic artery (HA) stenoses/occlusions, 2 inferior vena cava (IVC) stenoses, and 1 portal vein (PV) stenosis. Other interventions involved embolisation of the superior mesenteric artery branch to manage gastrointestinal bleeding in 2 patients and embolisation of an arteriobiliary fistula in 1 patient. RESULTS: Biliary: We carried out external-internal drainage and balloon dilatation of stenoses in 12 cases. The external-internal drainage catheter was removed after 6-8 weeks in 7 patients, with the remaining 5 patients with persisting stenosis assigned for retransplantation. We failed to cross anastomotic occlusions in 2 patients before completing the procedures using external drainage; both individuals subsequently underwent retransplantation. Vascular: We performed PTA/stenting of HA stenoses/occlusions in 4 out of 5 patients. After the procedure, all 4 patients showed liver function normalisation. All 3 cases of embolisation were technically and clinically successful. Both IVC and PV stenoses treated with dilatation/stenting were also successful. CONCLUSIONS: Percutaneous techniques used to treat biliary and vascular complications after liver transplantation in paediatric patients are safe and efficient.
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$a Kováč, Jozef $u Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021, Prague 4, Czech Republic.
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$a Prchlík, Martin $u Department of Pediatric and Trauma Surgery Third Faculty of Medicine, Charles University, Thomayer Teaching Hospital, Vídeňská 800, 14059, Prague 4, Czech Republic.
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$a Heinige, Pavel $u Department of Pediatric and Trauma Surgery Third Faculty of Medicine, Charles University, Thomayer Teaching Hospital, Vídeňská 800, 14059, Prague 4, Czech Republic.
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$a Kotanová, Radana $u Department of Pediatrics, Charles University, Second Faculty of Medicine, Motol University Hospital, V Úvalu 84, 150 06, Praha 5, Czech Republic.
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$a Froňek, Jiří $u Transplant Surgery Department, Charles University, Second Faculty of Medicine, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021, Prague 4, Czech Republic.
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$a Novotný, Róbert $u Transplant Surgery Department, Charles University, Second Faculty of Medicine, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021, Prague 4, Czech Republic.
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$a Kočík, Matěj $u Transplant Surgery Department, Charles University, Second Faculty of Medicine, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021, Prague 4, Czech Republic.
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$a Janoušek, Libor $u Transplant Surgery Department, Charles University, First Faculty of Medicine, Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 14021, Prague 4, Czech Republic.
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