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Hepatic artery stenosis after pediatric liver transplantation: The potential role of conservative management.

作者信息

Li Weihao, Kotsou Thomai, Hartog Hermien, Scheenstra Rene, de Meijer Vincent E, Stenekes Martin W, Verhagen Martijn V, Bokkers Reinoud P H, van der Doef Hubert P J

机构信息

Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands.

出版信息

Dig Liver Dis. 2025 Feb;57(2):502-511. doi: 10.1016/j.dld.2024.09.021. Epub 2024 Oct 7.

DOI:10.1016/j.dld.2024.09.021
PMID:39379231
Abstract

AIM

This study aimed to investigate the outcomes and effectiveness of various treatment strategies in patients with hepatic artery stenosis (HAS) after pediatric liver transplantation (pLT).

METHODS

This is a single center observational cohort study between January 1st, 2004 and August 1st, 2023, including pLT recipients aged <18 years. The primary outcome was graft and patient survival. The secondary outcomes included incidence of biliary complications, technical success of surgery or endovascular therapy (EVT), and changes in liver function. The cut-off for early and late HAS was 14 days after pLT.

RESULTS

Among a total of 327 pLT patients, 4 % (n = 13) developed HAS (n = 3 early; n = 10 late). Treatments included surgical revascularization for one early HAS, conservative management with anticoagulation for one early and four late HAS, and EVT for one early and six late HAS. Over a median follow-up of 28.2 months after the diagnosis of HAS, graft survival was 100 % and 83 % in early and late HAS groups, and patient survival reached 100 % in both groups. One graft loss occurred in the conservative group. Conversely, graft survival in the EVT group was 100 %.

CONCLUSION

The long-term outcomes of HAS after pLT are excellent. Both EVT and conservative management exhibited high graft survival rates for late HAS, with EVT achieving high technical success.

摘要

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