Related Experiment Video
Updated: Feb 22, 2026
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
Outcomes of Percutaneous Portal Vein Intervention in a Single UK Paediatric Liver Transplantation Programme
Ravi Patel1, Jeevan Mahaveer2, Nasim Tahir2
1School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Insights
Percutaneous transluminal angioplasty (PTA) for portal vein complications (PVC) after pediatric liver transplants shows excellent long-term success. Regular surveillance ensures high patency rates following these interventions.
Area of Science:
- Interventional Radiology
- Pediatric Hepatology
- Transplant Surgery
Background:
- Portal vein complications (PVC) are significant challenges after liver transplantation.
- Percutaneous transluminal angioplasty (PTA), with or without stenting, is the preferred treatment for PVC.
- Long-term outcomes in pediatric liver transplant recipients undergoing PTA for PVC require further assessment.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of percutaneous intervention for PVC in pediatric liver transplant recipients.
- To determine primary and primary-assisted patency rates following PTA for PVC.
- To analyze procedural success and complication rates in this specific patient population.
Main Methods:
- Retrospective analysis of 21 pediatric patients who underwent 42 percutaneous interventions for PVC between 2000 and 2016.
- Procedures included PTA for portal vein stenosis and thrombosis, with stenting reserved for suboptimal results.
- Technical success defined by pressure gradient reduction or venographic stenosis improvement; follow-up via Doppler ultrasound.
Main Results:
- Technical success was achieved in 41 out of 42 procedures (97.6%).
- Median primary patency was 9.9 months, with a 5-year primary-assisted patency of 95%.
- No major procedural complications were reported, with a median follow-up of 45.5 months.
Conclusions:
- Percutaneous intervention is a safe and effective treatment for PVC in pediatric liver transplant recipients.
- Excellent long-term patency rates can be achieved with regular Doppler ultrasound surveillance.
- PTA, with or without stenting, offers a durable solution for managing portal vein issues post-transplant.
Introduction:
Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution.
Materials And Methods:
227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention. Retrospective clinical and procedural outcome data on these 21 patients were collected.
Results:
21 patients, with median age 1.7 years (range 0.4-16.2), underwent 42 procedures with PTA with or without stenting. 36 procedures were for PV stenosis and 6 for PV thrombosis. Treatment was with primary PTA, with stenting reserved for suboptimal PTA result or restenosis within 3 months. 28 procedures were performed with PTA and 13 with stenting. Technical success (>50% reduction in mean pressure gradient, absolute pressure gradient ≤4 mmHg or venographic stenosis <30%) was achieved in 41 procedures. Failure to recanalise a thrombosed PV occurred in 1 procedure. There were no major procedural complications. Patients were followed-up with serial Doppler ultrasound surveillance. Kaplan-Meier estimated median primary patency was 9.9 months, with primary-assisted patency of 95% after median follow-up of 45.5 months (range 11.1-171.6).
Conclusion:
With regular surveillance, excellent patency rates can be achieved following percutaneous intervention for PVC post-paediatric liver transplantation.
