Early Portal Vein Thrombosis After Pediatric Split Liver Transplantation With Left Lateral Segment Graft
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...
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Veröffentlicht in: | Transplantation proceedings 2005-03, Vol.37 (2), p.1141-1142 |
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creator | 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. |
description | 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. |
doi_str_mv | 10.1016/j.transproceed.2004.11.034 |
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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.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2004.11.034</identifier><identifier>PMID: 15848649</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Blood and lymphatic vessels ; Cadaver ; Cardiology. Vascular system ; Child ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Survival ; Hepatectomy - methods ; Humans ; Liver Diseases - classification ; Liver Diseases - surgery ; Liver Transplantation - mortality ; Liver Transplantation - physiology ; Medical sciences ; Portal Vein ; Postoperative Complications - epidemiology ; Reoperation - statistics & numerical data ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Analysis ; Thrombosis - epidemiology ; Tissue and Organ Harvesting - methods ; Tissue Donors ; Tissue, organ and graft immunology</subject><ispartof>Transplantation proceedings, 2005-03, Vol.37 (2), p.1141-1142</ispartof><rights>2005 Elsevier Inc.</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-2b1f1fc779d525041fc7229e41e4e36591b8d4ca4d2395901a4780704bba0673</citedby><cites>FETCH-LOGICAL-c408t-2b1f1fc779d525041fc7229e41e4e36591b8d4ca4d2395901a4780704bba0673</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.transproceed.2004.11.034$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16847125$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15848649$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Corno, V.</creatorcontrib><creatorcontrib>Torri, E.</creatorcontrib><creatorcontrib>Bertani, A.</creatorcontrib><creatorcontrib>Guizzetti, M.</creatorcontrib><creatorcontrib>Lucianetti, A.</creatorcontrib><creatorcontrib>Maldini, G.</creatorcontrib><creatorcontrib>Pinelli, D.</creatorcontrib><creatorcontrib>Zambelli, M.</creatorcontrib><creatorcontrib>Aluffi, A.</creatorcontrib><creatorcontrib>Alberti, D.</creatorcontrib><creatorcontrib>Spada, M.</creatorcontrib><creatorcontrib>Gridelli, B.</creatorcontrib><creatorcontrib>Torre, G.</creatorcontrib><creatorcontrib>Colledan, M.</creatorcontrib><title>Early Portal Vein Thrombosis After Pediatric Split Liver Transplantation With Left Lateral Segment Graft</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>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.</description><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cadaver</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Survival</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Liver Diseases - classification</subject><subject>Liver Diseases - surgery</subject><subject>Liver Transplantation - mortality</subject><subject>Liver Transplantation - physiology</subject><subject>Medical sciences</subject><subject>Portal Vein</subject><subject>Postoperative Complications - epidemiology</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Analysis</subject><subject>Thrombosis - epidemiology</subject><subject>Tissue and Organ Harvesting - methods</subject><subject>Tissue Donors</subject><subject>Tissue, organ and graft immunology</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtr3DAQhUVpaTZp_0IRgfbNrkaWLbtvIU2TwkIDWdpHIcvjrBZfNpI2kH_f2eyS5rFPupwzZw4fY-cgchBQfd3kKdgpbsPsELtcCqFygFwU6g1bQK2LTFayeMsWJEAGhSpP2GmMG0FvqYr37ATKWtWVahZsfWXD8MRv55DswH-jn_hqHeaxnaOP_KJPGPgtdt6m4B2_2w4-8aV_pN_Vc4fBTskmP0_8j09rvsSedEtTlHaH9yNOiV8H26cP7F1vh4gfj-cZW_24Wl3eZMtf1z8vL5aZU6JOmWyhh95p3XSlLKk_3aVsUAEqLKqygbbulLOqk0VTNgKs0rXQQrWtFZUuztiXQyzRedhhTGb00eFAPXHeRVNprWWpSzJ-OxhdmGMM2Jtt8KMNTwaE2WM2G_Mas9ljNgCGMNPwp-OWXTuS9jJ65EqGz0eDjc4OPQU5H__5qlppkPsW3w8-JCSPHoOJzuPkiHhAl0w3-__p8xe8uqJ8</recordid><startdate>20050301</startdate><enddate>20050301</enddate><creator>Corno, V.</creator><creator>Torri, E.</creator><creator>Bertani, A.</creator><creator>Guizzetti, M.</creator><creator>Lucianetti, A.</creator><creator>Maldini, G.</creator><creator>Pinelli, D.</creator><creator>Zambelli, M.</creator><creator>Aluffi, A.</creator><creator>Alberti, D.</creator><creator>Spada, M.</creator><creator>Gridelli, B.</creator><creator>Torre, G.</creator><creator>Colledan, M.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050301</creationdate><title>Early Portal Vein Thrombosis After Pediatric Split Liver Transplantation With Left Lateral Segment Graft</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-2b1f1fc779d525041fc7229e41e4e36591b8d4ca4d2395901a4780704bba0673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cadaver</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Survival</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Liver Diseases - classification</topic><topic>Liver Diseases - surgery</topic><topic>Liver Transplantation - mortality</topic><topic>Liver Transplantation - physiology</topic><topic>Medical sciences</topic><topic>Portal Vein</topic><topic>Postoperative Complications - epidemiology</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Survival Analysis</topic><topic>Thrombosis - epidemiology</topic><topic>Tissue and Organ Harvesting - methods</topic><topic>Tissue Donors</topic><topic>Tissue, organ and graft immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Corno, V.</creatorcontrib><creatorcontrib>Torri, E.</creatorcontrib><creatorcontrib>Bertani, A.</creatorcontrib><creatorcontrib>Guizzetti, M.</creatorcontrib><creatorcontrib>Lucianetti, A.</creatorcontrib><creatorcontrib>Maldini, G.</creatorcontrib><creatorcontrib>Pinelli, D.</creatorcontrib><creatorcontrib>Zambelli, M.</creatorcontrib><creatorcontrib>Aluffi, A.</creatorcontrib><creatorcontrib>Alberti, D.</creatorcontrib><creatorcontrib>Spada, M.</creatorcontrib><creatorcontrib>Gridelli, B.</creatorcontrib><creatorcontrib>Torre, G.</creatorcontrib><creatorcontrib>Colledan, M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Corno, V.</au><au>Torri, E.</au><au>Bertani, A.</au><au>Guizzetti, M.</au><au>Lucianetti, A.</au><au>Maldini, G.</au><au>Pinelli, D.</au><au>Zambelli, M.</au><au>Aluffi, A.</au><au>Alberti, D.</au><au>Spada, M.</au><au>Gridelli, B.</au><au>Torre, G.</au><au>Colledan, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early Portal Vein Thrombosis After Pediatric Split Liver Transplantation With Left Lateral Segment Graft</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2005-03-01</date><risdate>2005</risdate><volume>37</volume><issue>2</issue><spage>1141</spage><epage>1142</epage><pages>1141-1142</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15848649</pmid><doi>10.1016/j.transproceed.2004.11.034</doi><tpages>2</tpages></addata></record> |
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subjects | Biological and medical sciences Blood and lymphatic vessels Cadaver Cardiology. Vascular system Child Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Survival Hepatectomy - methods Humans Liver Diseases - classification Liver Diseases - surgery Liver Transplantation - mortality Liver Transplantation - physiology Medical sciences Portal Vein Postoperative Complications - epidemiology Reoperation - statistics & numerical data Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Analysis Thrombosis - epidemiology Tissue and Organ Harvesting - methods Tissue Donors Tissue, organ and graft immunology |
title | Early Portal Vein Thrombosis After Pediatric Split Liver Transplantation With Left Lateral Segment Graft |
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