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
Hauptverfasser: 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.
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container_end_page 1142
container_issue 2
container_start_page 1141
container_title Transplantation proceedings
container_volume 37
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.
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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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