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Graft and patient survival following angioplasty for post-transplant portal vein stenosis in children under 7 years: a matched case-control study #MMPMID41389160
CVIR Endovasc 2025[Dec]; 8 (1): 113 PMID41389160show ga
BACKGROUND: Portal vein (PV) stenosis (PVS) is a common issue after pediatric liver transplantation (LT) and may be associated with severe morbidity. The purpose of this retrospective matched cohort study was to compare graft and patient survival after percutaneous angioplasty (PTA) for PVS in pediatric patients under 7 years with a control cohort without PVS and a cohort with chronic portal vein thrombosis (PVT). METHODS: This study included 31 patients with PVS (intervention group) and 62 patients without PVS (control group). Furthermore, 9 patients with chronic PVT were evaluated (negative control group). Primary endpoints were graft and patient survival. Secondary endpoints were comparison of liver function and clinical course (signs of portal hypertension), procedure-related complications, and long-term patency after PTA. RESULTS: Graft survival was comparable between the intervention and control group (p = 0.380), with 7-year survival rates of 93% (95% confidence interval [CI]: 84%, 100%) and 88% (95% CI: 80%, 97%), respectively. Graft survival was significantly higher in the intervention group compared to the negative control group p = 0.032; 7-year graft survival was 75% (95% CI: 50%, 100%). Patient survival was significantly higher in the intervention group (p = 0.034), with a 100% 7-year survival rate (95% CI: 100%, 100%) compared to 86% (95% CI: 78%, 96%) in the control group. Survival was reduced in the negative control group compared to the intervention group (p = 0.053). Seven-year patient survival in the negative control group was 88% (95% CI: 67%, 100%). There was one minor procedure-related complication (1/31 [3%]); long-term patency was 100%. CONCLUSIONS: Seven-year graft and patient survival after PTA for PVS were on par with that of patients without PVS. Graft survival was lower for patients with chronic PVT. Clinical course and liver function after PTA were comparable to patients without PVS. These findings, together with the low complication rate and high long-term patency, provide additional evidence supporting the efficacy of PTA in the management of PVS.
CVIR+Endovasc 2025 ; 8 (1): 113
