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Two-year outcomes of balloon-occluded retrograde transvenous obliteration of gastric varices in liver transplant recipients: A multi-institutional study.
Saad, W E; Chick, J F B; Srinivasa, R N; Saad, N; Kim, S; Fischman, A; Frey, G; Al-Osaimi, A; Caldwell, S.
Afiliação
  • Saad WE; Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Medical Center, Michigan Medicine, 1500, East Medical Center Drive, 48109 Ann Arbor, Michigan, USA.
  • Chick JFB; Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Medical Center, Michigan Medicine, 1500, East Medical Center Drive, 48109 Ann Arbor, Michigan, USA. Electronic address: jeffreychick@gmail.com.
  • Srinivasa RN; Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Medical Center, Michigan Medicine, 1500, East Medical Center Drive, 48109 Ann Arbor, Michigan, USA.
  • Saad N; Department of Radiology, Division of Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology, 63110 Saint-Louis, MO, USA.
  • Kim S; Department of Radiology, Division of Vascular and Interventional Radiology, Mallinckrodt Institute of Radiology, 63110 Saint-Louis, MO, USA.
  • Fischman A; Department of Radiology, Division of Vascular and Interventional Radiology, Mount Sinai Hospital, 10029 New York, NY, USA.
  • Frey G; Department of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, 55902 Rochester, MN, USA.
  • Al-Osaimi A; Department of Radiology, Division of Vascular and Interventional Radiology, University of Virginia Health System, 22908 Charlottesville, VA, USA.
  • Caldwell S; Department of Radiology, Division of Vascular and Interventional Radiology, University of Virginia Health System, 22908 Charlottesville, VA, USA.
Diagn Interv Imaging ; 98(11): 801-808, 2017 Nov.
Article em En | MEDLINE | ID: mdl-28416166
PURPOSE: To assess the 2-year effectiveness and safety of balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices (GVs) in liver transplant recipients. MATERIALS AND METHODS: Eleven liver transplant recipients underwent consecutive BRTO for GVs at four institutions. Patients included eight (73%) men and three (27%) women with mean age of 56 years±12 (SD) (range: 26-67 years). Underlying cause of liver transplantation was hepatitis C virus (HCV)-related cirrhosis in five (45%), alcohol- and HCV-related cirrhosis in three (27%), primary biliary cirrhosis in two (18%), and alcoholic cirrhosis in one (9%). Five (45%) patients underwent BRTO for actively bleeding GVs, three (17%) for high-risk GVs, and three (17%) for augmentation of portal venous flow through obliteration of gastrorenal shunts. Mean time between liver transplantation and BRTO was 78 months (range: 0.1-276 months). Technical success, GVs obliterative rates, and immediate complications were recorded. Post-BRTO hemorrhagic, transplant, and overall survival rates were evaluated at 6, 12, and 24 months. RESULTS: All (100%) procedures were technically successful. Complete GVs obliteration was achieved in ten patients (91%). Two major complications (18%) occurred in the immediate post-procedure period. One patient developed complete portal vein thrombosis, and another patient developed consumptive coagulopathy, ultimately leading to death. No post-BRTO hemorrhagic recurrences were seen at 6, 12, or 24 months. One patient (9%) had delayed upper gastrointestinal bleeding at 34 months after the procedure which was managed conservatively. Transplant and overall survival rates were 91% at 6, 12, and 24 months. CONCLUSION: BRTO has high technical success and complete GVs obliterative rates in liver transplant recipients with few complications and high graft survival rates.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Varizes Esofágicas e Gástricas / Transplante de Fígado / Oclusão com Balão / Hemorragia Gastrointestinal Tipo de estudo: Clinical_trials / Etiology_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Varizes Esofágicas e Gástricas / Transplante de Fígado / Oclusão com Balão / Hemorragia Gastrointestinal Tipo de estudo: Clinical_trials / Etiology_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article