Successful percutaneous transluminal angioplasty for hepatic artery stenosis in an infant undergoing living-related liver transplantation.
A 1-yr-old girl underwent a living-related liver transplant, with reconstruction of hepatic artery of 2 mm in diameter under microscopy. She developed intestinal perforation requiring closure on day 4 post-transplant and suffered from hepatic artery stenosis (HAS) on post-transplant day 9. Conservative therapies, such as intravenous or transluminal administration of anti-coagulants, vasodilators or fluids, were unsuccessful and caused remarkable general edema and multiple arrhythmias as a result of increased preload. On day 15 post-transplant, because flow velocity was remarkably reduced (as shown by Doppler ultrasound) the patient underwent percutaneous transluminal angioplasty (PTA) using a kit for coronary angioplasty. The balloon catheter was inflated [first: 1.5 mm diameter, 4 atmospheric pressure (a.p.) for 30 seconds (s); second: 2.0 mm diameter, 4 a.p. for 30 s; third: 2.5 mm diameter, 10 a.p. for 30 s]. The stenosis was successfully dilated without any complication. The patient has been doing well with normal liver functions for 4 months after PTA. From this experience, PTA can be performed for HAS after liver transplantation, even in an infantile case, with a careful technique and a special device.
Hasegawa
Toshimichi
T
Department of Pediatric Surgery, Osaka University, Medical School, Osaka, Japan. toshi@pedsurg.med.osaka-u.ac.jp
Sasaki
Takashi
T
Kimura
Takuya
T
Okada
Akira
A
Nakatsuchi
Yoshiaki
Y
Sugiura
Takashi
T
Kato
Hiromi
H
Nakajima
Yoshikazu
Y
D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000628:therapy*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D019520:Living Donors; D011183:Postoperative Complications / Q000628:therapy*