Arterial‐venous fistulas following pediatric liver transplant case studies

• Published in: Pediatric transplantation Vol. 11; no. 6; pp. 683 - 688
• Main Authors: Falkenstein, Kathleen, Flynn, Louise, Dunn, Stephen, Baldridge, Alan
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2007; Blackwell
• Subjects: Abdomen; Adolescent; arterial‐venous fistula; Arteriovenous Fistula - etiology; ascites; Biological and medical sciences; Child; Child, Preschool; Epstein Barr virus; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Hepatic Artery; Humans; Hypertension, Portal - complications; Hypertension, Portal - etiology; liver biopsy; liver transplant; Liver Transplantation - adverse effects; Male; Medical sciences; Other diseases. Semiology; percutaneous transhepatic cholangiogram; Portal Vein; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Pediatrics; Intravenous administration; Liver; Transplantation; Fistula; Epstein Barr virus; Homotransplantation; Percutaneous route; Surgery; Blood vessel; Graft; Vein; Child; liver transplant; percutaneous transhepatic cholangiogram; Gammaherpesvirinae; Human; Effusion; Digestive system; Herpesviridae; arterial- venous fistula; Artery; Infection; Virus; Case study; Anatomic pathology; Treatment; Biopsy; liver biopsy; Abdominal disease; Viral disease; Circulatory system; Ascites
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/j.1399-3046.2007.00742.x

:  AV fistula is a rare but serious complication following pediatric liver transplant and may lead to graft loss. Our aim was to describe two pediatric centers' experience with the diagnosis, treatment and outcomes of children who presented with AV fistulas post‐liver transplantation We report five cases of late arterio‐portal fistula following liver transplantation. Four children were successfully treated with coil embolization. All of the children in this series had liver biopsies within 2–6 months of their AV fistula diagnosis. All biopsies were performed using a Bard Monopty 18 gauge needle with no ultrasound guidance and only one pass per biopsy. Two children also had PTC 4–8 months prior to their diagnosis of AV fistula. Three of the five children in this series had GI bleeds requiring banding or sclerotherapy. The other two had varices found on CT scan. All five cases in this series had ascites on their initial presentation. Four out of the five children had a history of non‐compliance and the other child had a history of malabsorption and chronic diarrhea.