1. Treatments and outcomes of intra-operative portal vein thrombosis in living-donor liver transplantation due to biliary atresia.
- Author
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Wang K, Dong C, Sun C, Zheng W, Yang Y, Zhang F, Han C, Qin H, Xu M, Gao W, and Shen Z
- Subjects
- Humans, Child, Infant, Living Donors, Portal Vein surgery, Retrospective Studies, Treatment Outcome, Liver Transplantation adverse effects, Biliary Atresia surgery, Biliary Atresia complications, Venous Thrombosis epidemiology, Venous Thrombosis etiology, Liver Diseases complications
- Abstract
Background: Pediatric living-donor liver transplantation (LDLT) has become one of the most effective therapies for pediatric end-stage liver diseases. We aim to investigate the risk factors for intra-operative portal vein thrombosis (PVT) and the short- and long-term outcomes in children post LDLT., Methods: This was a retrospective analysis from 584 cases of biliary atresia (BA) patients who had undergone LDLT from January 2014 to December 2019 at our hospital. Patients were divided into PVT and non-PVT groups according to the occurrence of PVT during LDLT., Results: The median age of recipients at transplantation was 7.22 (quartiles, 6.03, 9.50) months, the incidence of intra-operative PVT was 5.31% (31/584). The independent risk factors for intra-operative PVT were the diameter of the recipient's PV not greater than 4 mm and a higher ratio of graft-to-recipient PV diameter. The cumulative survival rates of grafts and recipients were 93.5% and 93.5% in the PVT group, and 94.9% and 95.3% in the non-PVT group, respectively, without significant difference. The recovery of graft function was similar in recipients with or without interposed graft vessel (IGV). However, the incidence of PV stenosis was higher in recipients with IGV after LDLT., Conclusion: Intra-operative PVT is a common complication in pediatric LDLT, but an excellent prognosis can be achieved by appropriate and individualized surgical treatment. We noted that intra-operative PVT did not affect the survival rates of grafts and recipients, but there was a higher incidence of PV complications after LDLT., Level of Evidence: Ⅲ., Competing Interests: Declaration of competing interests The authors declare no conflicts of interest. We would like to thank all authors who contributed to this research and all authors are in agreement with the content of the manuscript. We certify that we have participated sufficiently in the work to take public responsibility for the experimental design and method, and the analysis and interpretation of the data., (Copyright © 2022. Published by Elsevier Inc.)
- Published
- 2022
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