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Clinical Outcomes of Percutaneous Transhepatic Biliary Drainage in Pediatric Patients following Liver Transplantation

Thorben Pape1, Ulrich Baumann2, Eva-Doreen Pfister2

  • 1Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Hannover, Germany.

Pediatric Gastroenterology, Hepatology & Nutrition
|March 20, 2025
PubMed

Insights

Percutaneous transhepatic biliary drainage (PTCD) is a safe and effective option for pediatric liver transplant patients with biliary complications. This procedure improves cholestasis and graft function, reducing the need for further interventions.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Interventional Radiology

Background:

  • Cholestatic complications are a major cause of morbidity in pediatric liver transplant recipients.
  • Standard endoscopic retrograde cholangioscopy may be challenging due to altered biliary anatomy post-transplantation.

Purpose of the Study:

  • To evaluate the safety and efficacy of percutaneous transhepatic biliary drainage (PTCD) in pediatric patients following liver transplantation (LTX).

Main Methods:

  • A retrospective analysis of procedural and safety characteristics of PTCD in pediatric LTX patients.
  • Comparison of laboratory indicators of inflammation, cholestasis, and graft function before and at 6 and 12 months post-PTCD.
  • Efficacy assessment based on rates of cholangitis, surgical re-intervention, and re-transplantation over 60 months.

Main Results:

  • PTCD achieved technical success in 14 out of 15 patients (93.3%) with acceptable periprocedural complication rates.
  • Significant reductions in MELD score and cholestasis parameters (GGT) were observed 12 months post-PTCD.
  • Post-PTCD, cholangitis incidence decreased from 64.3% to 7.1%, and rates of surgical re-intervention and re-transplantation were 35.7% and 14.3%, respectively.

Conclusions:

  • PTCD demonstrates an acceptable safety profile in pediatric liver transplant recipients.
  • The procedure leads to biochemical improvements in cholestasis and graft function.
  • PTCD may prevent further cholestatic complications, reducing the need for surgical re-intervention and re-transplantation.
Abstract

Keywords:
Anastomotic strictureCholestasisLiver transplantationPediatricsPercutaneous transhepatic biliary drainage

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