Background: Hepatic and portal vein stenosis are rare but critical complications after pediatric liver transplantation. While stent angioplasty is a viable treatment option, its use in children requires careful consideration due to ongoing vascular growth. This study aims to evaluate the long-term outcomes of pediatric liver transplant recipients who underwent stent placement for venous stenosis.
Methods: Among 266 pediatric liver transplant recipients (1999–2023), 19 underwent stent insertion for venous complications. This study retrospectively analyzed long-term outcomes of 14 patients with follow-up exceeding five years after stenting [median 7.5 (5–24) years].
Results: Seven patients had portal vein stenting, and seven had hepatic vein stenting, with a median interval of 54 days post-transplant. 12 patients (85.7%) showed prolonged ascites, and 8 patients (57.1%) had elevated liver enzymes on laboratory tests leading to stenting after transplantation. Although statistically insignificant, portal vein stenting cases demonstrated a higher proportion (71.4%) of primary stenting procedures compared to hepatic vein stenting (14.3%) cases, likely due to notable size discrepancies between graft and recipient portal veins. The primary patency rates were 85.7% at one year and 78.6% at five years. Reintervention free rate remained stable at 85.7% from one to five years after stenting. All seven patients with follow-up beyond 10 years maintained 100% patency. No procedure-related complications or mortality occurred, though one patient required retransplantation due to graft failure.
Conclusion: Percutaneous stent angioplasty is an effective and safe intervention for pediatric liver transplant recipients experiencing vein stenosis, demonstrating sustained patency and minimal complications in long-term follow-up.