Diagnostic and therapeutic experience of portal vein stenosis after pediatric liver transplantation from donation after citizen's death graft:a report of 30 cases
10.3760/cma.j.issn.0254-1785.2019.07.005
- VernacularTitle:儿童全肝移植术后门静脉狭窄30例诊治经验
- Author:
Yang YANG
1
;
Wei GAO
;
Nan MA
;
Chong DONG
;
Chao SUN
;
Xingchu MENG
;
Kai WANG
;
Hong QIN
;
Chao HAN
;
Zhongyang SHEN
Author Information
1. 天津市第一中心医院器官移植中心 300192
- Keywords:
pediatric liver transplantation;
portal vein stenosis;
balloon dilation
- From:
Chinese Journal of Organ Transplantation
2019;40(7):400-403
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the experiences of diagnosing and treating portal vein stenosis (PVS) after pediatric liver transplantation from China donation after citizen 's death (CDCD) grafts .Methods Retrospective analysis was performed for 30 cases of pediatric CDCD liver transplantation recipients with PVS .The screening ,diagnosis ,treatment and prognosis of PVS were analyzed .Results Among 218 pediatric liver transplantation recipients with CDCD grafts ,PVS was diagnosed in 30 cases with an incidence rate of 13 .8％ (30/218) .The initial diagnosis of PVS ranged from 5 days to 27 months post-operation with a median age of 2 .9 months .Ultrasonography indicated that stenotic rate of anastomotic site diameter was (41 .28 ± 12 .93)％ and blood flow velocity ratio (358 .77 ± 117 .82)％ .Intervention examination showed average pressure gradient was (9 .06 ± 5 .34) mmHg between both sides of stenosis . All cases underwent percutaneous intrahepatic balloon dilatation .The recipients were followed up for a median follow-up time of 23(3-63) months .For three cases of restenosis ,percutaneous intrahepatic balloon dilatation was repeated .Two cases underwent stent implantation due to ineffective balloon dilation .After treatment ,the stenotic rate of anastomotic site diameter was (34 .69 ± 8 .82) and blood flow velocity ratio (61 .18 ± 63 .11)％ on ultrasound while the average pressure gradient was (1 .03 ± 0 .85) mmHg .Conclusions PVS is a common vascular complication after pediatric CDCD liver transplantation .Portal vein balloon dilation is both safe and efficacious .However ,some cases require repeated balloon dilation and stent implantation serves as the last option for intractable PVS .Color ultrasound is both convenient and effective for making a primary diagnosis and evaluating outcomes .
