2026-04-17T07:55:52Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/135382025-10-24T10:37:20Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Sieben, Lydia author de Kleine, Ruben author Alfares, Bader author Wildhaber, Barbara author Casswall, Thomas author Nowak, Greg author quintero, jesus author MERCADAL-HALLY, MARIA MARGARET author Larrarte King, Mauricio author 2025-08-19T07:40:02Z 2025-08-19T07:40:02Z 2025-05 Liver transplantation; Portal vein; Vascular patency Trasplante de hígado; Vena porta; Permeabilidad vascular Trasplantament de fetge; Vena porta; Permeabilitat vascular Background and aims: Portal vein obstruction (PVO) is a known complication after pediatric liver transplantation (pLT). Effective management strategies are crucial in improving patient outcomes. This study investigated the various practice patterns related to PVO management to clarify the degree of consensus on the diverse facets of care involved in addressing PVO after pLT. Methods: A self-reported evaluation was conducted using a scanned, paper-based survey among specialized pLT centers participating in the Portal vein Obstruction Revascularization Therapy After Liver transplantation (PORTAL) registry. The survey consisted of 30 questions covering the current practices regarding PVO, including experience, team composition, follow-up and screening protocol, assessment criteria, postprocedural care, and radiologic follow-up. Results: The survey was returned by 25 centers (100%) from different regions worldwide. All centers used Doppler ultrasound (DUS) for PVO screening in the outpatient department. Noninvasive diagnostic criteria used during DUS assessment included anastomotic velocity (50%) and anastomotic-to-pre-anastomotic velocity ratio (54%). Digital subtraction angiography was used by 79% of respondents to diagnose portal vein anastomosis stenosis, which led to diagnostic cutoff values including a narrowing of the visual aspect of the anastomosis of ≥ 50% (80%) and a pressure gradient ≥ 5 mmHg (50%). PTA was identified as a standard treatment for PVO. A remarkable heterogeneity was observed in postinterventional anticoagulation and surveillance protocols. Conclusions: The care for PVO after pLT lacks standardization, resulting in substantial variation across healthcare centers. There is a need to establish a clear consensus on PVO management after pLT to guarantee optimal care. Trial Registration: NL9261. http://hdl.handle.net/11351/13538 Infants Fetge - Trasplantació - Complicacions Vena porta - Imatgeria Enquestes ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Digestive System Surgical Procedures::Surgical Procedures, Operative::Surgical Procedures, Operative::Liver Transplantation Other subheadings::Other subheadings::Other subheadings::/adverse effects ANATOMY::Cardiovascular System::Blood Vessels::Veins::Portal System::Portal Vein Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging NAMED GROUPS::Persons::Age Groups::Child ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos del sistema digestivo::intervenciones quirúrgicas::intervenciones quirúrgicas::trasplante de hígado Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ANATOMÍA::sistema cardiovascular::vasos sanguíneos::venas::sistema porta::vena porta Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios Portal Vein Obstruction in Pediatric Liver Transplant Patients: An Evaluation of Self-Reported Management Practices