title: Balloon-occluded retrograde transvenous obliteration for a portosystemic shunt after pediatric living-donor liver transplantation.
abstract: Portosystemic shunts may cause steal phenomenon after liver transplantation, which can lead to graft loss without proper management. Portal vein stenosis is one of the causes for the occurrence of portosystemic shunts after liver transplantation. Recently, new interventional radiologic techniques have been developed in the field of liver transplantation. Balloon-occluded retrograde transvenous obliteration (B-RTO) is a novel interventional technique for gastric varices and portosystemic shunts and also is effective for increasing portal vein flow. We herein report a pediatric case of portal vein stenosis with a large shunt successfully treated with a combination of balloon dilatation and B-RTO. If enlarged collateral vessels cause steal phenomenon, then B-RTO should be considered as an additional therapy.
authors.affiliation: Department of Transplant Surgery, National Center for Child Health and Development, Setagaya-ku, Tokyo, 157-8535, Japan. shigeta-t@ncchd.go.jp
authors.forename: Takanobu
authors.initials: T
authors.lastname: Shigeta
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Akinari
authors.initials: A
authors.lastname: Fukuda
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kakiuchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Matsuno
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Miyazaki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Isobe
authors.forename: Shunuke
authors.initials: S
authors.lastname: Nosaka
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakazawa
mesh_terms: D021721:Balloon Occlusion / Q000379:methods; D002404:Catheterization / Q000379:methods*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D008103:Liver Cirrhosis / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects; D011172:Portography; D018570:Risk Assessment; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology