No-touch hepatic hilum technique to treat early portal vein thrombosis after pediatric liver transplantation

J. Bueno, M. Perez-Lafuente, C. Venturi, A. Segarra, I. Barber, J. A. Molino, A. Romero, J. Ortega, I. Bilbao, V. Martinez-Ibañez, R. Charco

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11 Citations (Scopus)


A 'no-touch' hilum technique used to treat early portal vein complications post-liver transplantation in five children with body weight <10 kg is described. Four patients developed thrombosis and one portal flow absence secondary to collateral steal flow. A vascular sheath was placed through the previous laparotomy in the ileocolic vein (n = 2), inferior mesenteric vein (n = 1) or graft umbilical vein (n = 1). Portal clots were mechanically fragmented with balloon angioplasty. In addition, coil embolization of competitive collaterals (n = 3) and stent placement (n = 1) were performed. The catheter was left in place and exteriorized through the wound (n = 2) or a different transabdominal wall puncture (n = 3). A continuous transcatheter perfusion of heparin was subsequently administered. One patient developed recurrent thrombosis 24 h later which was resolved with the same technique. Catheters were removed surgically after a mean of 10.6 days. All patients presented portal vein patency at the end of follow-up. Three patients are alive after 5 months, 1.5 and 3.5 years, respectively; one patient required retransplantation 18 days postprocedure and the remaining patient died of adenovirus infection 2 months postprocedure. In conclusion, treatment of early portal vein complications following pediatric liver transplantation with this novel technique is feasible and effective. © 2010 The American Society of Transplantation and the American Society of Transplant Surgeons.
Original languageEnglish
Pages (from-to)2148-2153
JournalAmerican Journal of Transplantation
Issue number9
Publication statusPublished - 1 Sep 2010


  • Angioplasty
  • biliary atresia
  • children
  • liver transplantation
  • portal vein thrombosis

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