Aims and objectives
Liver transplant is the treatment option for the end stage liver diseases in children.
Pediatric transplant differs from that of an adult's in various aspects,
mainly due to the fact that patient size and hemodynamic characteristics vary with age,
creating a need for the use of partial or reduced-sized grafts in this age group (1,2).
Surgical complications of the hepatic transplant may be classified into venous,
arterial and biliary (2).
Therefore,
the purpose of this study was to analyse the pediatric liver transplantation complications in...
Methods and materials
Patient population: All pediatric patients who received a liver transplantation in our centre between 1/1/2012 and 28/11/2016,
were included.
Complications: Surgical complications were reviewed during the first 6 months after the transplantation.
We took into account arterial complications (stenosis and thrombosis) (Fig.
1-2),
venous complications (stenosis and thrombosis) (Fig.
3) and biliary complications (stenosis and bilomas) (Fig.
4).
Imaging techniques: The follow-up of the pediatric liver transplant in our centre includes Doppler ultrasound in the immediate postoperative moment of the intervention,
every 24 hours for...
Results
On that 5-year period 60 pediatric liver transplants were performed in our centre.
The average age at the transplant was 4,7±4,4 years (between 0,08-15,9 years).
The number of pediatric hepatic transplants in our centre has been increasing annually during the studied period (Fig.
5).
The main transplantation indication was Biliary Atresia (BA) (14 patients),
followed by metabolopathies (10 patients),
there were other indications such as cholestatic diseases,
cirrhosis and other diseases that represent a lower percentage of transplants.
Indications of pediatric liver transplantation varies in...
Conclusion
The highest rates of complications in pediatric liver transplants in our centre occurred in patients who received PT (72,4%) and in patients less than 2 years old (34,4% of all complications).
Basal disease plays an important role in the development of complications after a liver transplantation as it affects younger patients who may have subjacent arterial disease and who require partial liver transplants.
References
1.
Dyer-Hartnett S,
Coma A,
Hernandez C,
Riaza-Martin L,
Vazquez E.
Paediatric Liver Transplant Complications ; Implications For The Radiologist.
Eur Congr Radiol.
2017;1–55.
2.
Unsinn KM,
Freund MC,
Ellemunter H,
Ladurner R,
Gassner I,
Koenigsrainer A,
et al.
Spectrum of Imaging Findings After Pediatric Liver: Part I,
Transplantation Anatomy,
Posttransplantation.
Am J Roentgenol.
2003;181(October):1133–8.
3.
Berrocal T,
Parrón M,
Alvarez-Luque A,
Prieto C,
Santamaría ML.
Pediatric liver transplantation: a pictorial essay of early and late complications.
Radiographics.
2006;26(4):1187–209.
4.
Babyn PS.
Imaging of the...