Long-term graft and patient survival of patients with portal vein stenosis after pediatric liver transplantation; results from the multicenter multinational PORTAL registry.
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Alfares Bader A, Sieben Lydia, Kaliciński Piotr, Markiewicz-Kijewska Malgorzata, Koleśnik Adam, Cervio Guillermo, Minetto Julia, Sierre Sergio, Franchi-Abella Stéphanie, Gonzales Emmanuel, Guérin Florent, Kasahara Mureo, Sakamoto Seisuke, Uchida Hajime, de Kleine Ruben H, Verkade Henkjan J, Patel Jai V, Mtegha Marumbo, Prasad Raj, Wildhaber Barbara E, de Santibañes Martín, Ardiles Victoria, Uño Jimmy W, Marra Paolo, D'Antiga Lorenzo, Pinelli Domenico, Bernabeu Jesús Q, Mercadal-Hally Maria, Larrarte-King Mauricio, Evans Helen, Duncan David, McCall John, Beretta Marisa, Jaramillo Catalina, Bitterfeld Leandra, Melen Arielle, Hartleif Steffen, Sturm Ekkehard, Casswall Thomas, Nowak Greg, Delle Martin, Hardikar Winita, Aldrian Denise, Berchtold Valeria, Vogel Georg F, Khanna Rajeev, Pamecha Viniyendra, Mukund Amar, Mali Vidyadhar, Aw Marion, Fischer Ryan T, Mullapuddi Bhargava, Hendrickson Richard J, Shah Amit, Wood Phoebe, Acord Michael R, Lunter Gerton A, Ugwu Gibson C, van der Doef Hubert P J, Bokkers Reinoud P H, PORTAL registry investigators
Аннотация
METHODS: Our study analyzed data from the Portal vein Obstruction Revascularisation Therapy After Liver transplantation (PORTAL) registry, which contains retrospective data from 21 centers, across 18 countries, over a 20-year period. Graft- and patient survival rates were determined after PVS diagnosis.
RESULTS: This study included 239 patients (53% female; median age at pLT 1.1 years) diagnosed with PVS. The median age at diagnosis was 2.7 years. The overall ten-year graft survival was 90%, and the ten-year patient survival was 96%. One-year graft and patient survival was lowest in patients with PVS diagnosed ≤7 days after pLT (80% and 92%, respectively). Initial treatment strategies comprised of mostly endovascular procedures (87%), followed by conservative (11%) and surgical treatment (3%). Patient outcome did not differ between these treatment groups. Within the endovascular group, graft survival in patients treated with stent (n=26) was significantly lower compared to those with percutaneous transluminal angioplasty (n=181) (88% vs 98%, respectively, p=0.01).
CONCLUSIONS: Our findings indicate excellent graft and patient survival after PVS diagnosis and its treatment. Further research is needed to determine the safety and efficacy of optimal management strategies, especially in early-onset PVS.