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Review
. 2025 Sep;29(6):e70171.
doi: 10.1111/petr.70171.

Minimizing and Managing Hepatic Vein and Portal Vein Complications in Pediatric Liver Transplantation

João Seda Neto  1   2 , Eduardo A Fonseca  1   2
Affiliations
Review

Minimizing and Managing Hepatic Vein and Portal Vein Complications in Pediatric Liver Transplantation

João Seda Neto et al. Pediatr Transplant. 2025 Sep.

Abstract

Pediatric liver transplantation (PLT) is challenged by anatomical variability and small vessel size, especially in partial grafts. This review outlines strategies to minimize and manage complications of hepatic vein (HV) and portal vein (PV) reconstruction. HV reconstruction employs vein unification, direct caval implantation, or interposition grafts to prevent outflow obstruction, with diagnosis and management guided by imaging and interventional radiology. PV reconstruction in small recipients requires direct anastomosis, interposition grafts, or venoplasty, with intraoperative assessment of flow and pressure. PV thrombosis and stenosis are managed endovascularly or surgically, including Meso-Rex bypass. Individualized approaches and multidisciplinary care have improved outcomes in PLT.

Keywords: hepatic veins; liver transplantation; outcomes; portal vein; venous outflow.

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References

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