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.

Corno, V., Torri, E., Bertani, A., Guizzetti, M., Lucianetti, A., Maldini, G., et al. (2005). Early portal vein thrombosis after pediatric split liver transplantation with left lateral segment graft. TRANSPLANTATION PROCEEDINGS, 37(2), 1141-1142 [10.1016/j.transproceed.2004.11.034].

Early portal vein thrombosis after pediatric split liver transplantation with left lateral segment graft

Colledan M
2005

Abstract

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.
Articolo in rivista - Articolo scientifico
Alagille syndrome; anastomosis; bile duct atresia; child; conference paper; Doppler flowmetry; female; follow up; graft survival; human; incidence; infant; liver failure; liver graft; liver transplantation; major clinical study; male; mesenteriocaval anastomosis; portal vein thrombosis; priority journal; reoperation; retrospective study; revascularization; surgical mortality; survival rate; thrombectomy; treatment indication; treatment outcome;
English
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1142
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Corno, V., Torri, E., Bertani, A., Guizzetti, M., Lucianetti, A., Maldini, G., et al. (2005). Early portal vein thrombosis after pediatric split liver transplantation with left lateral segment graft. TRANSPLANTATION PROCEEDINGS, 37(2), 1141-1142 [10.1016/j.transproceed.2004.11.034].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/365640
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