Portal Vein Dilatation in The Liver Transplant Recipient

Portal vein stenoses are quite rare in liver transplant recipients except when interposition grafts are used to facilitate the surgical anastomosis.[1] Often these lesions are discovered with non-invasive screening tests such as ultrasound but can also present with symptoms related to portal hypertension. Because stenoses can progress to complete occlusions that portend a much worse prognosis, we have aggressively sought and dilated stenoses. When encountered, this type of vascular complication is effectively alleviated with percutaneous angioplasty.[2] [3] [4] [5] [6] Metallic stents have also been used effectively to treat recurrent and elastic stenoses.[6] [7] [8]

REFERENCES

• 1 Millis J M, Seaman D S, Piper J B et al.. Portal vein thrombosis and stenosis in pediatric liver transplantation.  Transplantation. 1996;  62 748-754
• 2 Raby N, Karani J, Thomas S, O'Grady J, Williams R. Stenosis of vascular anastomoses after hepatic transplantation: treatment with balloon angioplasty.  AJR Am J Roentgenol. 1991;  157 167-171
• 3 Rollins N K, Sheffield E G, Andrews W S. Portal vein stenosis complicating liver transplantation in children: percutaneous transhepatic angioplasty.  Radiology. 1992;  182 731-734
• 4 Zajko A B, Sheng R, Bron K, Reyes J, Nour B, Tzakis A. Percutaneous transluminal angioplasty of venous anastomotic stenoses complicating liver transplantation: intermediate-term results.  J Vasc Interv Radiol. 1994;  5 121-126
• 5 Funaki B, Rosenblum J D, Leef J A, Hackworth C A, Szymski G X, Alonso E M. Angioplasty treatment of portal vein stenosis in children with segmental liver transplants: mid-term results.  AJR Am J Roentgenol. 1997;  169 551-554
• 6 Cherukuri R, Haskal Z J, Naji A, Shaked A. Percutaneous thrombolysis and stent placement for the treatment of portal vein thrombosis after liver transplantation: long-term follow-up.  Transplantation. 1998;  65 1124-1126
• 7 Mathias K, Bolder U, Lohlein D, Jager H. Percutaneous transhepatic angioplasty and stent implantation for prehepatic portal vein obstruction.  Cardiovasc Intervent Radiol. 1993;  16 313-315
• 8 Funaki B, Rosenblum J D, Leef J A et al.. Percutaneous treatment of portal venous stenosis in children and adolescents with segmental hepatic transplants: long-term results.  Radiology. 2000;  215 147-151