Abstract No. 648 Balloon angioplasty without metallic stenting for treatment of pediatric liver transplant postoperative venous anastomotic stenosis: long-term results

Abstract

To describe our long-term experience using balloon angioplasty for treatment of portal and venous anastomotic stenosis in pediatric orthotopic liver transplant (OLT) patients without concomitant use of metal stents. With IRB approval, we retrospectively reviewed our pediatric OLT database for patients with significant venous anastomotic stenosis requiring treatment. Parameters analyzed included age at time of initial angioplasty, time from OLT to stenosis treatment. primary patency rate, time to stenosis recurrence, and long-term follow-up. Nineteen patients (12 female) underwent 37 angioplasty procedures. Eight patients had more than one OLT. In all patients, angioplasty was performed on their last liver. Mean age at first angioplasty was 6.3 years. Technical success was 100%. Treatment sites consisted of portal vein (13), IVC (5), mesocaval shunt (1). In the 12 patients (63%) requiring only one angioplasty, long-term patency post angioplasty was observed throughout their follow-up period (mean follow-up, 8 years; range, 1–18.3 years). Seven patients (37%) received more than one angioplasty. For those undergoing more than one angioplasty the mean interval between treatments was 18.8 months (median, 10.1 mo, range, 2 weeks-18 years). On long-term follow-up, 4 patients expired, unrelated to the procedure. Time from last treatment to time of death was 10.2 years, 8.6 years, 2.3 years and 0.1 years, respectively. Balloon angioplasty is an effective and durable method for the treatment of portal and venous anastomotic stenosis in pediatric liver transplant patients, avoiding use of metallic stents in growing children.