Interventional radiology treatment for vascular and biliary complications following pediatric living donor liver transplantation - a retrospective study

Transpl Int. 2018 Nov;31(11):1216-1222. doi: 10.1111/tri.13285. Epub 2018 Jun 20.

Abstract

There are few long-term outcome reports for interventional radiology (IVR) treatments for vascular and biliary complications following pediatric living donor liver transplantation (LDLT). Herein, we presented our institution's experience and investigated the efficacy and issues of long-term outcome with IVR treatments. Between May 2001 and September 2016, 279 pediatric LDLTs were performed. The median age at LDLT was 1.4 years old, and the median observation period was 8.2 years. All the biliary reconstructions at LDLT were hepaticojejunostomy. The IVR treatments were selected as endovascular, radiological, or endoscopic interventions. Post-transplant hepatic vein, portal vein, hepatic artery, and biliary complications were present in 7.9%, 14.0%, 5.4%, and 18.3%, respectively. IVR treatment was the first treatment option in 81.8%, 94.9%, 46.7%, and 94.1%, respectively. The recurrence and cure rates following IVR treatment were 42.1%, 21.1%, 44.4%, and 34.0% and 84.2%, 97.4%, 100%, and 88.0%, respectively. The graft survival rates in patients with and without post-transplant vascular and biliary complications were 94.4% and 90.6%, respectively (P = 0.522). The IVR treatments for vascular and biliary complications following pediatric LDLT are the first choice option. Although the recurrence following IVR treatment is a major problem and it is necessary to carefully perform long-term follow-up, IVR treatments have good treatment outcomes.

Keywords: interventional radiology; pediatric living donor liver transplantation; vascular and biliary complications.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Female
  • Graft Survival
  • Hepatic Artery / surgery*
  • Hepatic Veins / surgery*
  • Humans
  • Infant
  • Liver / blood supply
  • Liver Transplantation / adverse effects*
  • Living Donors*
  • Male
  • Portal Vein / surgery*
  • Radiology, Interventional*
  • Retrospective Studies
  • Risk Factors
  • Thrombosis / etiology
  • Thrombosis / therapy
  • Treatment Outcome