Percutaneous treatment of biliary complications in pediatric patients after liver transplantation

Area of Science:

• Hepatology
• Transplant Surgery
• Interventional Radiology

Background:

• Biliary complications are a significant concern following pediatric liver transplantation (PLT).
• Percutaneous interventions offer a less invasive alternative for managing these complications.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous transhepatic biliary drainage (PTBD) for biliary complications in pediatric liver transplant recipients.
• To assess technical and clinical success rates, complication profiles, and patient survival following PTBD.

Main Methods:

• Retrospective analysis of pediatric patients undergoing percutaneous biliary interventions post-PLT over a 4-year period.
• Detailed review of biliary complication types, intervention timing, procedural details, and outcomes including cholestasis, complications, and survival.

Main Results:

• 23 PTBD procedures were performed in 16 children for 18 biliary complications, achieving 100% technical and clinical success.
• PTBD was used for bridging to retransplantation, treating anastomotic leakage, and long-term dilation of biliary stenoses, with significant bilirubin reduction.
• One patient experienced bacteremia, and one case of recurrent stenosis was noted during follow-up.

Conclusions:

• Percutaneous transhepatic biliary drainage is an effective and safe treatment modality for biliary complications after pediatric liver transplantation.
• PTBD provides a valuable minimally invasive option for managing diverse biliary issues in this vulnerable patient population.