Early portal vein thrombosis after pediatric split liver transplantation with left lateral segment graft
| Autor: | A. Aluffi, Domenico Pinelli, M Guizzetti, M. Zambelli, Marco Spada, A Bertani, Elena Torri, Alessandro Lucianetti, G. Maldini, Daniele Alberti, Bruno Gridelli, V. Corno, Michele Colledan, Giuliano Torre |
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| Přispěvatelé: | Corno, V, Torri, E, Bertani, A, Guizzetti, M, Lucianetti, A, Maldini, G, Pinelli, D, Zambelli, M, Aluffi, A, Alberti, D, Spada, M, Gridelli, B, Torre, G, Colledan, M |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Cirrhosis
surgical mortality medicine.medical_treatment retrospective study treatment indication graft survival Liver transplantation mesenteriocaval anastomosi Postoperative Complications Medicine conference paper child liver transplantation Portal Vein bile duct atresia Liver Diseases Alagille syndrome anastomosi Thrombosis Tissue Donors Portal vein thrombosis female priority journal Doppler flowmetry thrombectomy Tissue and Organ Harvesting revascularization Radiology survival rate medicine.medical_specialty reoperation Anastomosis male Biliary atresia liver graft Cadaver Child Graft Survival Hepatectomy Humans Reoperation Retrospective Studies Survival Analysis Liver Transplantation follow up human portal vein thrombosi Transplantation business.industry liver failure medicine.disease infant major clinical study Surgery Split liver transplantation incidence treatment outcome Lateral segment business |
| Popis: | Early portal vein thrombosis (PVT) represents a serious complication after liver transplantation (OLTx). From October 1997 through July 2004, 260 OLTx were performed in 231 children, including 189 of left lateral segments (LLS). We retrospectively analyzed the incidence and the outcome of early PVT in this group. A daily doppler US scan was performed during the first week after transplantation. Early PVT occurred in 14 patients (8%), 10 males and four females of median age 0.77 years. The main indication for primary transplantation was biliary atresia (10), followed by Byler's disease (2), acute liver failure on cryptogenetic cirrhosis (1), and Alagille syndrome (1). Four children underwent retransplantation; three cases of thrombectomy and revision of the anastomosis, two children were treated with beta blockers, one of whom had a later failed attempt at percutaneous revascularization and eventually a meso-caval shunt. Five patients were followed with observation and no treatment. Among the four patients who died, three were in the retransplantation group and one in the thrombectomy and revision of the anastomosis group; the overall mortality was 28%. With a median follow up of 399 days, 10 patients are alive with an actuarial survival at 1 and 5 years of 72%, and graft survival rates at 1 and 5 years of 64%. PVT represents a serious complication after pediatric OLTx with LLS grafts. Prompt detection and aggressive surgical treatment in selected cases are required to reduce the mortality and graft loss. |
| Databáze: | OpenAIRE |
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