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Early posttransplantation portal vein stenosis following living donor liver transplantation: Percutaneous transhepatic primary stent placement
Author(s) -
Ko GiYoung,
Sung KyuBo,
Yoon HyunKi,
Lee SungGyu
Publication year - 2007
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21068
Subject(s) - medicine , liver transplantation , percutaneous , stenosis , portal vein , stent , radiology , surgery , living donor liver transplantation , transplantation , vein
Surgical treatments have usually been preferred for early posttransplantation portal inflow abnormalities. However, these treatments are limited due to their technical difficulty and multiple complicating factors. The present study reports the efficacy and safety of percutaneous transhepatic primary stent placement to treat early posttransplantation (≤1 month) portal vein (PV) stenosis. A total of 9 patients who had undergone living donor liver transplantation underwent percutaneous stent placement to treat PV stenosis. The average interval between liver transplantation and stent placement was 13 ± 10 days. Technical and clinical success was obtained in 7 (77.8%) of the 9 patients. Of the 7 patients with clinical success, 1 died of cerebral hemorrhage within 1 month following stent placement. The remaining 6 patients have remained healthy and without recurrence of PV stenosis until the time this manuscript was completed, and follow‐up Doppler ultrasound (US) or computed tomography (CT) obtained 66.6 ± 16.1 months after stent placement revealed patent portal inflow in all of these 6 patients. Major complications occurred in 3 patients, i.e., 2 cases of hemoperitoneum caused by blood oozing from a transhepatic tract of the liver grafts and 1 case of intrahepatic pseudoaneurysm. These complications were successfully treated using surgical ligation (n = 2) or transarterial coil embolization (n = 1). In conclusion, although we did experience some procedural complications, the percutaneous transhepatic primary stent placements in our study showed acceptable technical and clinical results for treating early posttransplantation PV stenosis. In addition, long‐term PV patency following stent placement was excellent. However, additional experience and further studies will be needed to verify the usefulness of primary stent placement in the early posttransplantation period. Liver Transpl 13:530–536, 2007. © 2007 AASLD.