Outcomes of Portosystemic Shunts in Children with and without Liver Transplantation.

Autor: Khan HH; Department of Pediatrics, Shawn Jenkins Children's Hospital, Medical University of South Carolina, Charleston, SC, USA., Kaufman SS; Department of Pediatrics, Transplant Institute, Medstar Georgetown University Hospital, Washington, D.C., USA., Yazigi NA; Department of Pediatrics, Transplant Institute, Medstar Georgetown University Hospital, Washington, D.C., USA., Khan KM; Department of Pediatrics, Transplant Institute, Medstar Georgetown University Hospital, Washington, D.C., USA.
Jazyk: angličtina
Zdroj: Pediatric gastroenterology, hepatology & nutrition [Pediatr Gastroenterol Hepatol Nutr] 2024 Jan; Vol. 27 (1), pp. 37-42. Date of Electronic Publication: 2024 Jan 09.
DOI: 10.5223/pghn.2024.27.1.37
Abstrakt: Purpose: Limited data exist regarding outcome and morbidity associated with portosystemic shunts in the pediatric transplant population. Our study assesses the outcomes of pediatric patients who underwent a portosystemic shunt procedure, both with and without liver transplantation (LT).
Methods: This study retrospectively reviewed the medical records of pediatric patients aged 0-19 years who underwent shunt placement between 2003 and 2017 at a tertiary care center. The analysis included cases of shunt placement with or without LT.
Results: A total of 13 pediatric patients were included in the study with median age of 8.8 years. Among the cases, 11 out of 13 (84.6%) underwent splenorenal shunt, 1 (7.7%) underwent a mesocaval shunt, and another 1 (7.7%) underwent a Modified Rex (mesoportal) shunt. Additionally, 5 out of 13 (38.5%) patients had LT, with 4 out of 5 (80.0%) receiving the transplant before shunt placement, and 1 out of 5 (20.0%) receiving it after shunt placement. Gastrointestinal bleeding resulting from portal hypertension was the indication in all cases. A total of 10 complications were reported in 5 patients; the most common complication was anemia in 3 (23.1%) patients. At the most recent follow-up visit, the shunts were functional without encephalopathy, and no deaths were reported.
Conclusion: Shunt placement plays a crucial role in the management of patients with portal hypertension. Our study demonstrates favorable long-term outcomes in pediatric patients who underwent shunt placement. Long term shunt outcomes were similar and unremarkable in patients with LT and without LT.
Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest.
(Copyright © 2024 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition.)
Databáze: MEDLINE
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