Interventional Radiological Treatment of Paediatric Liver Transplantation Complications
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
32043199
DOI
10.1007/s00270-020-02430-8
PII: 10.1007/s00270-020-02430-8
Knihovny.cz E-resources
- Keywords
- Liver transplantation biliary complications, Liver transplantation vascular complications, Paediatric liver transplantation,
- MeSH
- Arterial Occlusive Diseases diagnostic imaging therapy MeSH
- Cholestasis diagnostic imaging therapy MeSH
- Child MeSH
- Drainage methods MeSH
- Radiology, Interventional methods MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Postoperative Complications diagnostic imaging therapy MeSH
- Child, Preschool MeSH
- Stents MeSH
- Embolization, Therapeutic methods MeSH
- Liver Transplantation * MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
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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