Frequency of and factors associated with vascular complications after pediatric liver transplantation ,

Jornal de Pediatria

Mariana Orlandini¹  Flávia Heinz Feier¹  Brunna Jaeger¹  Carlos Kieling¹  Sandra Gonçalves Vieira¹  Maria Lucia Zanotelli¹ 

关键词: Thrombosis;    Hepatic artery;    Portal vein;    Morbidity;    Mortality;    Trombose;    Artéria hepática;    Veia porta;    Morbidez;    Mortalidade;   

DOI  :  10.1016/j.jped.2013.08.010

来源: SciELO

【 摘 要 】

OBJECTIVE:to evaluate the frequency and factors associated with vascular complications after pediatric liver transplantation.METHOD:risk factors were evaluated in 99 patients under 18 years of age with chronic liver disease who underwent deceased donor liver transplantation (DDLT) between March of 1995 and November of 2009 at the Hospital de Clínicas de Porto Alegre, Brazil. The variables analyzed included donor and recipient age, gender, and weight; indication for transplant; PELD/MELD scores; technical aspects; postoperative vascular complications; and survival.RESULTS:vascular complications occurred in 19 patients (19%). Arterial events were most common, occurred earlier in the postoperative period, and were associated with high graft loss and mortality rates. In the multivariate analysis, the following factors were identified: portal vein diameter < 3 mm, donor-to-recipient body weight ratio (DRWR), prolonged ischemic time, and use of arterial grafts.CONCLUSION:the choice of treatment depends on the timing of diagnosis; however, in this study, surgical revision or correction produced worse outcomes than percutaneous angioplasty. The reduction of risk factors and early detection of vascular complications are key elements to a successful transplantation.

【 授权许可】

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