Stent Placement for the Treatment of Portal Vein Stenosis or Occlusion in Pediatric Liver Transplant Recipients

Abstract

To evaluate the efficacy of stent placement for the treatment of portal vein (PV) stenosis or occlusion in pediatric liver transplant recipients. Written informed consent was obtained from a legal guardian, and our institutional review board approved this study. Percutaneous (n = 10) or intraoperative (n = 2) stent placement was attempted in 12 pediatric recipients (age range, 6-102 months) via the percutaneous transhepatic or inferior mesenteric vein route. Stents 6-10 mm in diameter were placed. Technical and clinical success, complications, and patency of the PV were retrospectively analyzed. Technical success was achieved in 10 of 12 patients (83%) and clinical success was achieved in eight patients (67%). Eight of the 10 patients in whom technical success was achieved (80%) remained healthy with a patent PV during the 10-58-month clinical follow-up period. One patient with technical success died of acute rejection without recurrent PV complications and another died of acute rejection after stent replacement as a result of an hourglass deformity of a deployed stent with partial thrombosis. No major procedural complications occurred. Based on this study in a relatively small number of patients, PV stent placement seems to be a safe and effective method for the treatment of posttransplantation PV stenosis or occlusion in pediatric patients.