When is surgery required for the treatment of biliary complications after pediatric liver transplantation?

Neto, João Seda; Chapchap, Paulo

doi:10.1002/lt.23932

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…At other centers, donor criteria are far more stringent and there is little reliance on cadaveric grafts. Preoperative donor evaluation includes blood counts, coagulation profile, renal and hepatic function tests, and viral serology . Absolute limits outlined by Seda‐Neto et al .…”

Section: Discussionmentioning

confidence: 99%

Reducing the incidence of hepatic artery thrombosis in pediatric liver transplantation: Effect of microvascular techniques and a customized anticoagulation protocol

Ziaziaris

Darani

Holland

et al. 2017

Pediatric Transplantation

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We aimed to assess the incidence of HAT over three eras following implementation of microvascular techniques and a customized anticoagulation protocol in a predominantly cadaveric split liver transplant program. We retrospectively reviewed pediatric liver transplants performed between April 1986 and 2016 and analyzed the incidence HAT over three eras. In E1, 1986-2008, each patient received a standard dose of 5 U/kg/h of heparin and coagulation profiles normalized passively. In E2, 2008-2012, microvascular techniques were introduced. In E3, 2012-2016, in addition, a customized anticoagulation protocol was introduced which included replacement of antithrombin 3, protein C and S, and early heparinization. A total of 317 liver transplants were completed during the study period, with a median age of 31.7 months. In E1, 22% of grafts were cadaveric in situ split grafts, while the second and third eras used split grafts in 59.0% and 64.9% of cases, respectively. HAT occurred in 9.5% in the first era, 11.5% (P=.661) in the second, and dropped to 1.8% in the third era (P=.043). A routine anticoagulation protocol has significantly reduced the incidence of HAT post-liver transplantation in children in a predominantly cadaveric in situ split liver transplant program.

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Section: Discussionmentioning

confidence: 99%

Reducing the incidence of hepatic artery thrombosis in pediatric liver transplantation: Effect of microvascular techniques and a customized anticoagulation protocol

Ziaziaris

Darani

Holland

et al. 2017

Pediatric Transplantation

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“…The place of surgical treatment in the management of BC after pediatric LT is not well defined: in the past, it was the only treatment available for BC [ 3 , 38 ], being progressively indicated only in the management of bile leaks and in case of failure of interventional radiology [ 35 , 39 , 40 ], even if surgery is still being used as first-line therapy in some centers [ 21 ]. Surgical revision was successful in our series for saving strictures not amenable to radiologic treatment.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation

Calinescu,

Monluc,

Franchi-Abella

et al. 2024

BMC Res Notes

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Objectives We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients). Results In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4–21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaired by BC (p = 0.01). Multivariate analysis identified the number of dilatation courses > 2 (p = 0.008), prolonged cold ischemia time (p = 0.004), anastomosed multiple biliary ducts (p = 0.019) and hepatic artery thrombosis (p = 0.01) as factors associated with impaired graft survival. The number of dilatation courses > 2 (p < 0.001) and intrahepatic vs anastomotic stricture (p = 0.014) were associated with management failure. Thus, repeated (> 2) radiologic dilatation courses are associated with impaired graft survival and management failure. Overall, graft but not patient survival was impaired by BC.

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Analysis of Factors Associated With Biliary Complications in Children After Liver Transplantation

et al. 2016

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When is surgery required for the treatment of biliary complications after pediatric liver transplantation?

Cited by 4 publications

References 16 publications

Reducing the incidence of hepatic artery thrombosis in pediatric liver transplantation: Effect of microvascular techniques and a customized anticoagulation protocol

Reducing the incidence of hepatic artery thrombosis in pediatric liver transplantation: Effect of microvascular techniques and a customized anticoagulation protocol

Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation

Analysis of Factors Associated With Biliary Complications in Children After Liver Transplantation

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