Sistema de Salut de Catalunya
Institut Català de la Salut
[Sieben L] Department of Pediatrics, University Medical Center Groningen, Division of Pediatric Gastroenterology and Hepatology, University of Groningen, Groningen, The Netherlands. Department of Radiology Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. [Alfares BA] Department of Radiology Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. [de Kleine RH] Department of Surgery, University Medical Center Groningen, Division of Hepatobiliary Surgery & Liver Transplantation, University of Groningen, Groningen, The Netherlands. [Wildhaber BE] Swiss Pediatric Liver Center, Division of Child and Adolescent Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. [Casswall T] Department Clinical Interventions and Technology CLINTEC, Division for Paediatrics, Karolinska Institute, Stockholm, Sweden. [Nowak G] Department Clinical Interventions and Technology CLINTEC, Division for Transplantation Surgery, Karolinska Institute, Stockholm, Sweden. [Quintero J, Mercadal Hally M, Larrarte King M] Unitat de Gastroenterologia, Hepatologia, Suport Nutricional i Trasplantaments Hepàtics Pediàtrics, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-08-19T07:40:02Z
2025-08-19T07:40:02Z
2025-05
Liver transplantation; Portal vein; Vascular patency
Trasplante de hígado; Vena porta; Permeabilidad vascular
Trasplantament de fetge; Vena porta; Permeabilitat vascular
Background and aims: Portal vein obstruction (PVO) is a known complication after pediatric liver transplantation (pLT). Effective management strategies are crucial in improving patient outcomes. This study investigated the various practice patterns related to PVO management to clarify the degree of consensus on the diverse facets of care involved in addressing PVO after pLT. Methods: A self-reported evaluation was conducted using a scanned, paper-based survey among specialized pLT centers participating in the Portal vein Obstruction Revascularization Therapy After Liver transplantation (PORTAL) registry. The survey consisted of 30 questions covering the current practices regarding PVO, including experience, team composition, follow-up and screening protocol, assessment criteria, postprocedural care, and radiologic follow-up. Results: The survey was returned by 25 centers (100%) from different regions worldwide. All centers used Doppler ultrasound (DUS) for PVO screening in the outpatient department. Noninvasive diagnostic criteria used during DUS assessment included anastomotic velocity (50%) and anastomotic-to-pre-anastomotic velocity ratio (54%). Digital subtraction angiography was used by 79% of respondents to diagnose portal vein anastomosis stenosis, which led to diagnostic cutoff values including a narrowing of the visual aspect of the anastomosis of ≥ 50% (80%) and a pressure gradient ≥ 5 mmHg (50%). PTA was identified as a standard treatment for PVO. A remarkable heterogeneity was observed in postinterventional anticoagulation and surveillance protocols. Conclusions: The care for PVO after pLT lacks standardization, resulting in substantial variation across healthcare centers. There is a need to establish a clear consensus on PVO management after pLT to guarantee optimal care. Trial Registration: NL9261.
Article
Published version
English
Infants; Fetge - Trasplantació - Complicacions; Vena porta - Imatgeria; Enquestes; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Digestive System Surgical Procedures::Surgical Procedures, Operative::Surgical Procedures, Operative::Liver Transplantation; Other subheadings::Other subheadings::Other subheadings::/adverse effects; ANATOMY::Cardiovascular System::Blood Vessels::Veins::Portal System::Portal Vein; Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging; NAMED GROUPS::Persons::Age Groups::Child; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::intervenciones quirúrgicas::intervenciones quirúrgicas::trasplante de hígado; Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos; ANATOMÍA::sistema cardiovascular::vasos sanguíneos::venas::sistema porta::vena porta; Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen; DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios
Wiley
Health Science Reports;8(5)
https://doi.org/10.1002/hsr2.70625
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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