title: Successful percutaneous transluminal balloon dilatation for hepatic venous outflow obstruction after pediatric liver transplantation: A series of cases.
abstract: OBJECTIVE
  Whether percutaneous transluminal balloon dilatation (PTBD) or stent placement should be used in children with hepatic venous outflow obstruction (HVOO) is still controversial. The aim of the present study was to retrospectively describe experience in diagnosis and treatment of HVOO and to evaluate the outcome of PTBD in HVOO patients after pediatric liver transplantation (P-LT).
  
  
  METHODS
  From January 2001 to January 2011, 54 children received P-LT at our center. The clinical features of children with HVOO analyzed included demography, type of donor and liver transplant, the new-onset symptoms, liver function test, interventional examination, and treatment and outcome.
  
  
  RESULTS
  Three children were treated successfully with PTBD without stenting. All patients received percutaneous interventional management successfully. In the total of eight episodes of PTBD across the stenosis, the mean pressure gradient ± standard deviation was 16.6 ± 7.90 mmHg before PTBD and 6.8 ± 2.27 mmHg after PTBD. The difference was significant (P < 0.05). All of the three HVOO patients were still surviving with primary graft functioning normally until the last follow up.
  
  
  CONCLUSIONS
  HVOO after P-LT should be taken seriously. PTBD is an effective and safe treatment for HVOO in younger patients subjected to P-LT and re-venoplasty is recommended even in patients with recurrent HVOO.
authors.affiliation: Department of Organ Transplantation, First Central Hospital, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Rao
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Sun
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Zhu
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.forename: Xiao-Ye
authors.initials: XY
authors.lastname: Sun
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Rui
authors.initials: R
authors.lastname: Shi
keywords: hepatic venous outflow obstruction; pediatric liver transplantation; percutaneous transluminal balloon dilatation; pressure gradient; recurrent