The role of endoscopic ultrasound for evaluating portal hypertension in children being assessed for intestinal transplantation.

Abstract:

:Intestinal transplant is an established treatment of irreversible intestinal failure, unless complicated by advanced intestinal failure-associated liver disease, when liver-bowel transplant may be necessary. Finding at least moderate hepatic fibrosis or gastroesophageal varices (GOV) at oesophago-gastroduodenoscopy (OGD) has been an indication for combined transplantation. Endoscopic ultrasound (EUS) is a sensitive method for detection of GOV. We hypothesized that EUS would detect early GOV and decrease the need for liver biopsy. Sixteen children, median age 13 months (range, 7-88), being assessed for intestinal transplant underwent simultaneous OGD and EUS. In 9 of 16 patients the results of OGD and EUS were concordant, that is, both positive (2) or both negative (7) for GOV. In seven patients, GOV were only identified by EUS. Liver biopsy was avoided in four of these cases. EUS is superior to OGD for detecting GOV in children with intestinal failure-associated liver disease and results in fewer liver biopsies being necessary.

journal_name

Transplantation

journal_title

Transplantation

authors

McKiernan PJ,Sharif K,Gupte GL

doi

10.1097/TP.0b013e3181891d63

subject

Has Abstract

pub_date

2008-11-27 00:00:00

pages

1470-3

issue

10

eissn

0041-1337

issn

1534-6080

pii

00007890-200811270-00022

journal_volume

86

pub_type

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