The usefulness of portal venous stenting with self-expandable metallic stent in pediatric living donor liver transplantation

Portal vein (PV) steno-occlusive disease is a known vascular complication after liver transplantation. The use of portal venous stenting (PVS) is encouraging because it provides longer vessel patency. The purpose of this study is to assess the therapeutic usefulness of self-expandable PVS in pediatric living donor liver transplantation (LDLT) recipients with PV complications. Between July 2008-July 2011, twelve pediatric recipients (M/F: 2/10; mean age=3.3 years; range=9months-9.8 years) were diagnosed to have anastomotic stenosis of the portal vein (4 occlusions and 8 stenoses). PVS with self-expandable metallic stents (SEMS) were deployed where the size varied from 7.0-10.0 mm in diameter. The mean follow-up time was 26 months (0-36 months). After deployment of SEMS, the mean PV diameter was expanded to 72% of the original diameter (4.2-8.0 mm) and then increased to 85% (5.5-9.3 mm) at 6 months, 90% (6.1-9.5 mm) at 12 months, and 91% (6.5-9.1 mm) at 24 months and at almost full expansion of 94% (7.0-9.6 mm) at 36 months follow-up. The stent patency rate was 100%). In small pediatric patients, despite the continued growth of pediatric recipients, the long-term patency of the gradually self-expandable metallic stents is able to maintain enough PV flow to accommodate the physiological function of the donated liver grafts.