Frequency of and factors associated with vascular complications after pediatric liver transplantation
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 o...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | Portuguese |
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Brazilian Society of Pediatrics
2014-03-01
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| Series: | Jornal de Pediatria (Versão em Português) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255553614000330 |
| _version_ | 1811255225891160064 |
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| author | Mariana Orlandini Flávia Heinz Feier Brunna Jaeger Carlos Kieling Sandra Gonçalves Vieira Maria Lucia Zanotelli |
| author_facet | Mariana Orlandini Flávia Heinz Feier Brunna Jaeger Carlos Kieling Sandra Gonçalves Vieira Maria Lucia Zanotelli |
| author_sort | Mariana Orlandini |
| collection | DOAJ |
| description | 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 andmortality rates. In the multivariate analysis, the following factors were identified: portal veindiameter ≤ 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. |
| first_indexed | 2024-04-12T17:20:35Z |
| format | Article |
| id | doaj.art-6d700f8d366e45919fabeb2c7457c1a9 |
| institution | Directory Open Access Journal |
| issn | 2255-5536 |
| language | Portuguese |
| last_indexed | 2024-04-12T17:20:35Z |
| publishDate | 2014-03-01 |
| publisher | Brazilian Society of Pediatrics |
| record_format | Article |
| series | Jornal de Pediatria (Versão em Português) |
| spelling | doaj.art-6d700f8d366e45919fabeb2c7457c1a92022-12-22T03:23:29ZporBrazilian Society of PediatricsJornal de Pediatria (Versão em Português)2255-55362014-03-0190216917510.1016/j.jpedp.2013.08.008Frequency of and factors associated with vascular complications after pediatric liver transplantationMariana Orlandini0Flávia Heinz Feier1Brunna Jaeger2Carlos Kieling3Sandra Gonçalves Vieira4Maria Lucia Zanotelli5Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BrasilGrupo de Transplante Hepático Pediátrico, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BrasilUniversidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, BrasilHepatologia Pediátrica e Transplante Hepático, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BrasilHepatologia Pediátrica e Transplante Hepático, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BrasilGrupo de Transplante Hepático Pediátrico, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, BrasilObjective: 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 andmortality rates. In the multivariate analysis, the following factors were identified: portal veindiameter ≤ 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.http://www.sciencedirect.com/science/article/pii/S2255553614000330ThrombosisHepatic arteryPortal veinMorbidityMortality |
| spellingShingle | Mariana Orlandini Flávia Heinz Feier Brunna Jaeger Carlos Kieling Sandra Gonçalves Vieira Maria Lucia Zanotelli Frequency of and factors associated with vascular complications after pediatric liver transplantation Jornal de Pediatria (Versão em Português) Thrombosis Hepatic artery Portal vein Morbidity Mortality |
| title | Frequency of and factors associated with vascular complications after pediatric liver transplantation |
| title_full | Frequency of and factors associated with vascular complications after pediatric liver transplantation |
| title_fullStr | Frequency of and factors associated with vascular complications after pediatric liver transplantation |
| title_full_unstemmed | Frequency of and factors associated with vascular complications after pediatric liver transplantation |
| title_short | Frequency of and factors associated with vascular complications after pediatric liver transplantation |
| title_sort | frequency of and factors associated with vascular complications after pediatric liver transplantation |
| topic | Thrombosis Hepatic artery Portal vein Morbidity Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2255553614000330 |
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