Intervetional therapy for portal vein occlusion after liver tansplantation / 中华器官移植杂志

ABSTRACT

Objective +o evaluate percutaneous intervetional therapy for portal vein anastomotic occlusion after liver transplantation.Method From July 2005 to July 2013,13 patients (9 male and 4 female; aged 25-65 years) with portal vein occlsion underwent interventional therapy.All patients accepted the imaging examation and 8 patients had typical clinical signs of portal hypertension.Percutaneous hepatic balloon venoplasty and stent placement was performed,trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways performed if necessary.+echnical success rate,complication rate and clinical symptoms were analyzed.Follow-ups including clinical course,stent patency and potal vein thrombosis which evaluated by imaging were performed.Result +echnical success was achieved in l1of 13 patients (84.6％) and 15 stents were deployed.Seven patients with localized portal vein occulsion accepted balloon dilation and stents deployment,4 patients with long segment cculsion also accept trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways.Portal vein flow recovered in all 11 patients.Procedure related complication occurred in 2 patient with hemothorax.During the follow-up period of 4-42 months,the clinical signs of portal hypertension were not observed in all patients.Stent stenosis was found in one patient with ultrasound in 23 months,but stent patency was proved by the percutaneous portal angiography.Conclusion Interventional therapy is effective for portal vein occulsion after liver transplantation,comprehensive interventional therapy should be performed in long segment portal vein cculsion.