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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Portal vein stenosis is a relatively rare complication after liver transplant (LT), which sometimes leads to a life-threatening event due to gastrointestinal bleeding or graft failure. The aim of this study was to evaluate the diagnoses and management of portal vein stenoses in pediatric LT recipients at our center. Between September 2001and June 2008, 103 living-donor LT (LDLT) procedures were done in 100 children at our center, among which 91 children with a functioning graft at 3 months after LDLT are included in this analysis. Five instances of portal vein stenosis (4.8%) were diagnosed, and these were analyzed retrospectively. The portal vein was anastomosed without a vein graft in all children. The preangioplasty and postangioplasty pressure gradients were recorded. The median age of the patients was 3.1 years (range, 6 months to 11 years); the median body weight was 17 kg (range, 6-37 kg). Portal vein stenoses were detected at 6, 8, 10, 11, and 14 months after LDLT. While splenomegaly and massive ascites were observed in 1 child, the remaining 4 children were asymptomatic at the time of diagnosis. All children were treated with transhepatic balloon dilatation. We did not observe any treatment-related complications. The mean pressure gradient decreased from 13 to 2.06 mm Hg after treatment. Portal venous patency was maintained in all children at 4, 19, 35, 36, and 38 months’ follow-up. There were no recurrences of stenosis during follow-up. In conclusion, percutaneous transhepatic balloon angioplasty is an effective treatment for the portal vein stenoses that occur after LDLT. Our center has had good results with this technique.

Volume : 6
Issue : 4
Pages : 115

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Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey.