Determinants of early surgical complications after pediatric liver transplantation: A single center/single surgeon experience over 20 years.

Autor: Boillot O; Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; University Claude Bernard Lyon 1, France., Guillaud O; Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; Ramsay Générale de Santé, Clinique de la Sauvegarde, France., Wischlen E; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France., Ruiz M; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France., Boucaud C; Department of Anesthesiology, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, Lyon, France., Rohmer B; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France., Lachaux A; University Claude Bernard Lyon 1, France; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France., Rivet C; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France., Laverdure N; Department of Pediatric Hepatogastroenterology and Nutrition, Centre National de Référence de l'Atrésie des Voies Biliaires et des Cholestases Génétiques, Femme-Mère-Enfant Hospital, Hospices Civils de Lyon, France., Dumortier J; Department of Digestive Diseases, Edouard Herriot Hospital, Hospices Civils de Lyon, France; University Claude Bernard Lyon 1, France. Electronic address: jerome.dumortier@chu-lyon.fr.
Jazyk: angličtina
Zdroj: Clinics and research in hepatology and gastroenterology [Clin Res Hepatol Gastroenterol] 2023 Nov; Vol. 47 (9), pp. 102222. Date of Electronic Publication: 2023 Oct 01.
DOI: 10.1016/j.clinre.2023.102222
Abstrakt: Background: The risk of early surgical complications of liver transplantation (LT) is higher in children when compared with adults. The aims of the present retrospective study from a single center cohort/single surgeon were to identify the predictive factors for surgical complications after pediatric LT.
Methods: All children receiving a first LT from October 1990 to October 2010 in our center were included.
Results: Included 151 children (boys 55.0%), with a mean age of 4.8 ± 4.8 years, and a mean weight of 17.9 ± 14.4 kg. Thirty-seven patients were transplanted within the first year, and 59 patients had a body weight below 10 kg. The main initial liver disease was biliary atresia (49.0%). Living donor LT was performed in 39 cases (25.8%), cadaveric whole liver LT in 50 cases (33.1%), and cadaveric partial liver LT in 62 cases (41.1%). Early surgical complications included reoperation (37.8%), vascular complications (8.6%), i.e. arterial (3.3%) or portal thrombosis/stenosis (7.3%) within the first month, and biliary complications in the first 90 days occurred in 22.5% of the cases. The main indications for surgical revision were abdominal bleeding, treatment of a biliary complication, and bowel perforation. Multivariate analysis disclosed that only graft type (split and moreover from a living donor) was significantly and independently associated with the occurrence of biliary complication, and that indication for LT, period, graft type, and operative time were significantly and independently associated with the necessity of surgical revision.
Conclusion: Our results emphasize that surgical complications are frequent and strongly depend on patient/graft characteristics.
Competing Interests: Declaration of Competing Interest None of the authors have any conflict of interest disclosures to make.
(Copyright © 2023. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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