Novel Technique for Management of Post-Transplant Refractory Diarrhea in Children with PFIC-1
Abstract:
Methods: Retrospective observational case series study of 3 patients with PFIC type 1 who underwent LT (Liver Transplant) with one of them had biliary diversion (BD) after LT while all of them had their Roux loop marked during the transplantation procedure. The patient who underwent BD had a novel technique of external drainage of bile performed by the interventional radiology owing to the previous marking of the Roux loop facilitating the access to the biliary diversion without the need for major surgical intervention.
Results: Biliary diversion post liver transplantation for Case 1 resulted in moderate clinical and histopathological improvements. Specifically, that the patient experienced a reduction in bowel movements, diarrhea, and itching. Additionally, the severity of hepatic steatosis decreased from severe to moderate, and there was no progression of f ibrosis. Marking the Roux loop during the transplantation procedure facilitated less invasive intervention in the early postoperative period.
Conclusion: Marking the Roux loop during the transplantation procedure for PFIC 1 is a novel and straightforward technique. It can be easily implemented when needed to address post-liver transplant complications such as diarrhea or steatosis. This approach should be considered as a preemptive measure to avoid more invasive surgical interventions in the future, facilitating easier and more accessible interventional radiology.
