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The Impact of Hepatic Artery Thrombosis on the Outcome of Pediatric Living Donor Liver Transplantations.
Stefanowicz, Marek; Kalicinski, Piotr; Kowalewski, Grzegorz; Kowalski, Adam; Ciopinski, Mateusz; Szymczak, Marek; Kwiecinska, Agnieszka; Patkowski, Waldemar; Zieniewicz, Krzysztof; Grzelak, Ireneusz; Kaminska, Diana; Ismail, Hor.
Afiliação
  • Stefanowicz M; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Kalicinski P; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Kowalewski G; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Kowalski A; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Ciopinski M; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Szymczak M; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Kwiecinska A; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Patkowski W; Department of General Surgery, Transplantation and Liver Surgery, Warsaw Medical University, 02-091 Warsaw, Poland.
  • Zieniewicz K; Department of General Surgery, Transplantation and Liver Surgery, Warsaw Medical University, 02-091 Warsaw, Poland.
  • Grzelak I; Department of General Surgery, Transplantation and Liver Surgery, Warsaw Medical University, 02-091 Warsaw, Poland.
  • Kaminska D; Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
  • Ismail H; Department of Pediatric Surgery and Organ Transplantation, The Children's Memorial Health Institute, 04-730 Warsaw, Poland.
Children (Basel) ; 10(2)2023 Feb 09.
Article em En | MEDLINE | ID: mdl-36832468
ABSTRACT
The aim of our study was to assess risk factors for hepatic artery thrombosis (HAT) and to evaluate the impact of HAT management on long-term outcomes after pediatric living donor liver transplantation (LDLT). We retrospectively analyzed 400 patients who underwent primary LDLT between 1999 and 2020. We compared preoperative data, surgical factors, complications, and patient and graft survivals in patients with HAT (HAT Group) and without HAT (non-HAT Group). A total of 27 patients (6.75%) developed HAT. Acute liver failure, a hepatic artery (HA) anastomosis diameter below 2 mm, and intraoperative HA flow dysfunction were significantly more common in the HAT Group (p < 0.05, p = 0.02026, and p = 0.0019, respectively). In the HAT Group, 21 patients (77.8%) underwent urgent surgical revision. The incidence of biliary stenosis and retransplantation was significantly higher in the HAT Group (p = 0.00002 and p < 0.0001, respectively). Patient and graft survivals were significantly worse in the HAT Group (p < 0.05). The close monitoring of HA flow with Doppler ultrasound during the critical period of 2 to 3 weeks after LDLT and the immediate attempt of surgical revascularization may attenuate the elevated risk of biliary stenosis, graft loss, and the need for retransplantation due to HAT.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article