Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme
Introduction Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single in...
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| Veröffentlicht in: | Cardiovascular and interventional radiology 2018-01, Vol.41 (1), p.96-103 |
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| creator | Patel, Ravi Mahaveer, Jeevan Tahir, Nasim Rajwal, Sanjay McClean, Patricia Patel, Jai V. |
| description | Introduction
Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution.
Materials and Methods
227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention. Retrospective clinical and procedural outcome data on these 21 patients were collected.
Results
21 patients, with median age 1.7 years (range 0.4–16.2), underwent 42 procedures with PTA with or without stenting. 36 procedures were for PV stenosis and 6 for PV thrombosis. Treatment was with primary PTA, with stenting reserved for suboptimal PTA result or restenosis within 3 months. 28 procedures were performed with PTA and 13 with stenting. Technical success (>50% reduction in mean pressure gradient, absolute pressure gradient ≤4 mmHg or venographic stenosis |
| doi_str_mv | 10.1007/s00270-017-1792-0 |
| format | Article |
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Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution.
Materials and Methods
227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention. Retrospective clinical and procedural outcome data on these 21 patients were collected.
Results
21 patients, with median age 1.7 years (range 0.4–16.2), underwent 42 procedures with PTA with or without stenting. 36 procedures were for PV stenosis and 6 for PV thrombosis. Treatment was with primary PTA, with stenting reserved for suboptimal PTA result or restenosis within 3 months. 28 procedures were performed with PTA and 13 with stenting. Technical success (>50% reduction in mean pressure gradient, absolute pressure gradient ≤4 mmHg or venographic stenosis <30%) was achieved in 41 procedures. Failure to recanalise a thrombosed PV occurred in 1 procedure. There were no major procedural complications. Patients were followed-up with serial Doppler ultrasound surveillance. Kaplan–Meier estimated median primary patency was 9.9 months, with primary-assisted patency of 95% after median follow-up of 45.5 months (range 11.1–171.6).
Conclusion
With regular surveillance, excellent patency rates can be achieved following percutaneous intervention for PVC post-paediatric liver transplantation.</description><identifier>ISSN: 0174-1551</identifier><identifier>EISSN: 1432-086X</identifier><identifier>DOI: 10.1007/s00270-017-1792-0</identifier><identifier>PMID: 28913651</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Angioplasty ; Cardiology ; Children ; Clinical Investigation ; Complications ; Doppler effect ; Imaging ; Implants ; Intervention ; Liver ; Liver transplantation ; Liver transplants ; Materials selection ; Medicine ; Medicine & Public Health ; Nuclear Medicine ; Patients ; Polyvinyl chloride ; Portal vein ; Pressure ; Radiology ; Restenosis ; Stenosis ; Surgical implants ; Surveillance ; Thromboembolism ; Thrombosis ; Transplantation ; Transplants ; Transplants & implants ; Ultrasound</subject><ispartof>Cardiovascular and interventional radiology, 2018-01, Vol.41 (1), p.96-103</ispartof><rights>The Author(s) 2017</rights><rights>CardioVascular and Interventional Radiology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-f0f332383c4f842de4a750c165571affb834da1c975f6f723b4c4a9cea377af73</citedby><cites>FETCH-LOGICAL-c470t-f0f332383c4f842de4a750c165571affb834da1c975f6f723b4c4a9cea377af73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00270-017-1792-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00270-017-1792-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28913651$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Ravi</creatorcontrib><creatorcontrib>Mahaveer, Jeevan</creatorcontrib><creatorcontrib>Tahir, Nasim</creatorcontrib><creatorcontrib>Rajwal, Sanjay</creatorcontrib><creatorcontrib>McClean, Patricia</creatorcontrib><creatorcontrib>Patel, Jai V.</creatorcontrib><title>Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme</title><title>Cardiovascular and interventional radiology</title><addtitle>Cardiovasc Intervent Radiol</addtitle><addtitle>Cardiovasc Intervent Radiol</addtitle><description>Introduction
Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution.
Materials and Methods
227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention. Retrospective clinical and procedural outcome data on these 21 patients were collected.
Results
21 patients, with median age 1.7 years (range 0.4–16.2), underwent 42 procedures with PTA with or without stenting. 36 procedures were for PV stenosis and 6 for PV thrombosis. Treatment was with primary PTA, with stenting reserved for suboptimal PTA result or restenosis within 3 months. 28 procedures were performed with PTA and 13 with stenting. Technical success (>50% reduction in mean pressure gradient, absolute pressure gradient ≤4 mmHg or venographic stenosis <30%) was achieved in 41 procedures. Failure to recanalise a thrombosed PV occurred in 1 procedure. There were no major procedural complications. Patients were followed-up with serial Doppler ultrasound surveillance. Kaplan–Meier estimated median primary patency was 9.9 months, with primary-assisted patency of 95% after median follow-up of 45.5 months (range 11.1–171.6).
Conclusion
With regular surveillance, excellent patency rates can be achieved following percutaneous intervention for PVC post-paediatric liver transplantation.</description><subject>Angioplasty</subject><subject>Cardiology</subject><subject>Children</subject><subject>Clinical Investigation</subject><subject>Complications</subject><subject>Doppler effect</subject><subject>Imaging</subject><subject>Implants</subject><subject>Intervention</subject><subject>Liver</subject><subject>Liver transplantation</subject><subject>Liver transplants</subject><subject>Materials selection</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Patients</subject><subject>Polyvinyl chloride</subject><subject>Portal vein</subject><subject>Pressure</subject><subject>Radiology</subject><subject>Restenosis</subject><subject>Stenosis</subject><subject>Surgical implants</subject><subject>Surveillance</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><subject>Transplantation</subject><subject>Transplants</subject><subject>Transplants & implants</subject><subject>Ultrasound</subject><issn>0174-1551</issn><issn>1432-086X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV9rFDEUxYModq1-AF8k4Isvozf_NjMvghStxYUu2Ipv4W42WVNnkm0ys-C3b-rUUgWfknB-99x7cwh5yeAtA9DvCgDX0ADTDdMdb-ARWTAp6qVdfn9MFlWQDVOKHZFnpVwBMNVy9ZQc8bZjYqnYgvw8n0abBldo8nTtsp1GjC5Nha5THrGn31yI9CyOLh9cHEOKtL6Rfg1x1zt6-YWu0W0DjjlYugoHl-lFxlj2PcYRf_PrnHYZh8E9J0889sW9uDuPyeWnjxcnn5vV-enZyYdVY6WGsfHgheCiFVb6VvKtk6gVWLZUSjP0ftMKuUVmO6380msuNtJK7KxDoTV6LY7J-9l3P20Gt7V17oy92ecwYP5lEgbztxLDD7NLB6O0UBxYNXhzZ5DT9eTKaIZQrOv7-WsM6yRAhUFV9PU_6FWacqzrVUq3nIkaQqXYTNmcSsnO3w_DwNxGaeYoTYXNbZQGas2rh1vcV_zJrgJ8BkqV4s7lB63_63oDTPyrFQ</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Patel, Ravi</creator><creator>Mahaveer, Jeevan</creator><creator>Tahir, Nasim</creator><creator>Rajwal, Sanjay</creator><creator>McClean, Patricia</creator><creator>Patel, Jai V.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180101</creationdate><title>Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme</title><author>Patel, Ravi ; Mahaveer, Jeevan ; Tahir, Nasim ; Rajwal, Sanjay ; McClean, Patricia ; Patel, Jai V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-f0f332383c4f842de4a750c165571affb834da1c975f6f723b4c4a9cea377af73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Angioplasty</topic><topic>Cardiology</topic><topic>Children</topic><topic>Clinical Investigation</topic><topic>Complications</topic><topic>Doppler effect</topic><topic>Imaging</topic><topic>Implants</topic><topic>Intervention</topic><topic>Liver</topic><topic>Liver transplantation</topic><topic>Liver transplants</topic><topic>Materials selection</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Patients</topic><topic>Polyvinyl chloride</topic><topic>Portal vein</topic><topic>Pressure</topic><topic>Radiology</topic><topic>Restenosis</topic><topic>Stenosis</topic><topic>Surgical implants</topic><topic>Surveillance</topic><topic>Thromboembolism</topic><topic>Thrombosis</topic><topic>Transplantation</topic><topic>Transplants</topic><topic>Transplants & implants</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Ravi</creatorcontrib><creatorcontrib>Mahaveer, Jeevan</creatorcontrib><creatorcontrib>Tahir, Nasim</creatorcontrib><creatorcontrib>Rajwal, Sanjay</creatorcontrib><creatorcontrib>McClean, Patricia</creatorcontrib><creatorcontrib>Patel, Jai V.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cardiovascular and interventional radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Ravi</au><au>Mahaveer, Jeevan</au><au>Tahir, Nasim</au><au>Rajwal, Sanjay</au><au>McClean, Patricia</au><au>Patel, Jai V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme</atitle><jtitle>Cardiovascular and interventional radiology</jtitle><stitle>Cardiovasc Intervent Radiol</stitle><addtitle>Cardiovasc Intervent Radiol</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>41</volume><issue>1</issue><spage>96</spage><epage>103</epage><pages>96-103</pages><issn>0174-1551</issn><eissn>1432-086X</eissn><abstract>Introduction
Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution.
Materials and Methods
227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention. Retrospective clinical and procedural outcome data on these 21 patients were collected.
Results
21 patients, with median age 1.7 years (range 0.4–16.2), underwent 42 procedures with PTA with or without stenting. 36 procedures were for PV stenosis and 6 for PV thrombosis. Treatment was with primary PTA, with stenting reserved for suboptimal PTA result or restenosis within 3 months. 28 procedures were performed with PTA and 13 with stenting. Technical success (>50% reduction in mean pressure gradient, absolute pressure gradient ≤4 mmHg or venographic stenosis <30%) was achieved in 41 procedures. Failure to recanalise a thrombosed PV occurred in 1 procedure. There were no major procedural complications. Patients were followed-up with serial Doppler ultrasound surveillance. Kaplan–Meier estimated median primary patency was 9.9 months, with primary-assisted patency of 95% after median follow-up of 45.5 months (range 11.1–171.6).
Conclusion
With regular surveillance, excellent patency rates can be achieved following percutaneous intervention for PVC post-paediatric liver transplantation.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28913651</pmid><doi>10.1007/s00270-017-1792-0</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Angioplasty Cardiology Children Clinical Investigation Complications Doppler effect Imaging Implants Intervention Liver Liver transplantation Liver transplants Materials selection Medicine Medicine & Public Health Nuclear Medicine Patients Polyvinyl chloride Portal vein Pressure Radiology Restenosis Stenosis Surgical implants Surveillance Thromboembolism Thrombosis Transplantation Transplants Transplants & implants Ultrasound |
| title | Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme |
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