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balloon dilatation for treatment of hepatic venous outflow obstruction following pediatric liver transplantation

World Journal of Gastroenterology 2017年第46期23卷 8227-8234页

作者： Zhi-Yuan Zhang Long Jin Guang Chen Tian-Hao Su Zhi-Jun Zhu Li-Ying Sun Zhen-Chang Wang Guo-Wen Xiao Department of Interventional Radiology Beijing Friendship HospitalCapital Medical University Department of Transplantation Surgery Beijing Friendship HospitalCapital Medical University Department of Radiology Beijing Friendship HospitalCapital Medical University

AIM To assess the efficacy and safety of balloon dilatation for the treatment of hepatic venous outflow obstruction(HVOO) following pediatric liver *** A total of 246 pediatric patients underwent liver transplantation at our hospital between June 2013 and September 2016. Among these patients, five were ultimately diagnosed with HVOO. Seven procedures(two patients underwent two balloon dilatation procedures) were included in this analysis. The demographic data,types of donor and liver transplant, interventional examination and therapeutic outcomes of these five children were analyzed. The median interval time between pediatric liver transplantation and balloon dilatation procedures was 9.8 mo(range: 1-32).RESULTS Five children with HVOO were successfully treated by balloon angioplasty without stent placement, with seven procedures performed for six stenotic lesions. All children underwent successful percutaneous intervention. Among these five patients, four were treated by single balloon angioplasty, and these patients did not develop recurrent stenosis. In seven episodes of balloon angioplasty across the stenosis, the pressure gradient was 12.0 ± 8.8 mm Hg before balloon dilatation and 1.1 ± 1.5 mm Hg after the procedures, which revealed a statistically significant reduction(P balloon dilatation is an effective and safe therapeutic option for HVOO in children undergoing pediatric liver transplantation. Venous angioplasty is also recommended in cases with recurrent HVOO.

关键词： Hepatic venous outflow obstruction Pediatric liver transplantation percutaneous transluminal balloon dilatation Pressure gradient Recurrent

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