Alfares, B.A. (Bader) (2019) Portal vein anastomotic stenosis after liver transplantation in pediatrics: evaluation of the standard of care in the Netherlands. thesis, Medicine.
Full text available on request.Abstract
Background: Portal vein anastomotic stenosis (PVAS) is a frequent complication after liver transplantation in pediatrics. Percutaneous transluminal angioplasty (PTA) is currently the first treatment option. When PTA fails to restore adequate portal flow, a surgical mesorex bypass (MRB) can be performed to increase the graft survival and quality of life in these pediatric patients. The aim of this study was to evaluate the clinical evaluation and treatment of patients with a PVAS by means of PTA and MRB. Methods and materials: In the period of 2014 to 2018 at our center, we retrospectively studied patients ≤18 years old who were evaluated for PVAS and treated by means of PTA and/or MRB. The primary and secondary patency after PTA and MRB were analyzed and evaluated. Results: Twenty-one patients were evaluated for PVAS clinically and radiologically. The median follow-up was 1.9 years for all procedures combined. The primary patency was 64, 60, 46 and 38% at 0.5, 1, 2, and 3 years, respectively. The secondary patency was 90, 87, 83, and 78% at 0.5, 1, 2, and 3 years, respectively. Conclusion: Based on our findings, it can be concluded that treatment of patients with PVAS leads to increased portal patency and improved clinical outcome. This combined treatment approach by means of PTA with or without stent and/or MRB has a good clinical outcome, with a secondary patency of 78% at 3 years.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Bokkers dr. R. P. H.MD PhD and Doef dr. H. P. J. van der MD PhD and This research was conducted in Department of Radiology of Me |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2287 |
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