Non-operative management of biliary complications after Liver Transplantation in pediatric patients: A 30-year...

Area of Science:

• Pediatric Hepatology
• Transplant Surgery
• Interventional Gastroenterology

Background:

• Biliary strictures and leaks are common complications following pediatric liver transplantation (LT).
• Effective management strategies are crucial for long-term graft survival and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of percutaneous and endoscopic interventions for biliary complications post-pediatric LT.
• To determine the long-term success rates of minimally invasive treatments for biliary strictures and leaks.

Main Methods:

• Retrospective analysis of 49 pediatric liver transplant recipients with biliary strictures or leaks.
• Assessment of minimally invasive treatments including percutaneous and endoscopic approaches.
• Clinical success defined by biliary patency and/or leak resolution without further intervention.

Main Results:

• Long-term success was achieved in 57% of children with biliary strictures and 57% with biliary leaks after a mean follow-up of 13.8 years.
• Only one re-transplant was directly attributed to treatment failure.
• Younger age at diagnosis was associated with treatment failure in biliary strictures (p < .02).

Conclusions:

• Percutaneous and endoscopic management provides durable results in over 50% of pediatric LT recipients with biliary complications.
• Minimally invasive interventions are effective options for managing biliary strictures and leaks in this population.