Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
October 14, 2026 · via Europe PMC
Long-term graft and patient survival of patients with portal vein stenosis after pediatric liver transplantation; results from the multicenter multinational PORTAL registry.
Alfares BA, Sieben L, Kaliciński P, +57 more, PORTAL registry investigators.
AI summary — for doctors, generated from the abstract only
Long-term graft and patient survival after portal vein stenosis in pediatric liver transplant recipients is excellent, though early-onset stenosis and stent use were associated with poorer graft outcomes.
What was studied
A retrospective analysis of the multinational PORTAL registry (21 centers, 18 countries, 20 years) of 239 children diagnosed with portal vein stenosis after pediatric liver transplantation, examining graft and patient survival and treatment strategy.
Key findings
- Ten-year graft survival was 90% and ten-year patient survival was 96%
- One-year graft and patient survival were lowest when stenosis was diagnosed within 7 days of transplant (80% and 92%)
- Most initial treatment was endovascular (87%), with conservative (11%) and surgical (3%) approaches less common; within the endovascular group, graft survival was lower with stents (n=26) than angioplasty (n=181) (88% vs 98%, p=0.01)
Clinical relevance
Clinicians can reassure families that outcomes after treated portal vein stenosis are generally very good, while recognizing early-onset cases as higher risk. The stent versus angioplasty difference may inform treatment choice but is hypothesis-generating.
Who should care
Limitations
The data are retrospective and registry-based, the stent group was small, and treatment selection was not randomized, so confounding is likely. The authors state the optimal strategy, especially for early-onset stenosis, remains unclear.
Outcomes are excellent overall, but early stenosis and the best intervention need further study.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background and aims
Pediatric liver transplantation (pLT) has become a standard treatment, but it is still burdened by complications such as portal vein stenosis (PVS). PVS can result in compromised graft function and portal hypertension if left untreated. We aimed to assess long-term patient and graft survival after PVS diagnosis after pLT.
Methods
Our study analyzed data from the Portal vein Obstruction Revascularisation Therapy After Liver transplantation (PORTAL) registry, which contains retrospective data from 21 centers, across 18 countries, over a 20-year period. Graft- and patient survival rates were determined after PVS diagnosis.
Results
This study included 239 patients (53% female; median age at pLT 1.1 years) diagnosed with PVS. The median age at diagnosis was 2.7 years. The overall ten-year graft survival was 90%, and the ten-year patient survival was 96%. One-year graft and patient survival was lowest in patients with PVS diagnosed ≤7 days after pLT (80% and 92%, respectively). Initial treatment strategies comprised of mostly endovascular procedures (87%), followed by conservative (11%) and surgical treatment (3%). Patient outcome did not differ between these treatment groups. Within the endovascular group, graft survival in patients treated with stent (n=26) was significantly lower compared to those with percutaneous transluminal angioplasty (n=181) (88% vs 98%, respectively, p=0.01).
Conclusions
Our findings indicate excellent graft and patient survival after PVS diagnosis and its treatment. Further research is needed to determine the safety and efficacy of optimal management strategies, especially in early-onset PVS.
DOI
10.1097/lvt.0000000000001018
PMID
42879377
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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