Portosystemic Shunt in Pediatric Living Donor Liver Transplant |
| |
| Affiliation: | 1. Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;2. Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;1. Department of Surgery, Incheon St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;2. Department of Surgery, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea;1. Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan;2. Department of Medicine, Emory University, Atlanta, Georgia;1. Division of Nephrology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia;2. Division of Laboratory Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia;1. Department of Internal Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital;2. Department of Laboratory Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital;3. Department of Surgery, Hallym University College of Medicine, Kangdong Sacred Heart Hospital;4. Department of Surgery, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea;1. Division of Nephrology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia;2. Division of Nephrology, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia |
| |
| Abstract: | BackgroundTo evaluate the significance of portosystemic shunts and associated long-term outcomes in living donor liver transplant (LDLT) among pediatric patients.MethodsRetrospective review of 121 pediatric patients who underwent LDLT between May 1994 and December 2015 at Taiwan Kaohsiung Chang Gung Memorial Hospital. Pre- and postoperative computed tomography images of the liver were reviewed, and portal vein complications were assessed.ResultsNinety-seven pediatric patients were included in the study, and 70 had portosystemic shunts before transplant. Thirty-three patients have portal systemic shunt (PSS) 6 months after transplant (mean [SD] shunt size, 4.59 [1.98] mm). Thirty-seven patients’ portosystemic shunts closed spontaneously (mean [SD] shunt size, 3.14 [1.06] mm). Smaller PSSs tend to close spontaneously with a cutoff point of 3.35 mm by receiver operating characteristic curve (P = .01). Patients with PSS have more portal vein complications than those without PSS (44.3% vs 11.1%, P = .02). Among PSS recipients, patients with portal vein complications tend to have larger PSS size (mean [SD], 4.14 [1.96] mm vs 3.59 [1.48] mm), although the difference is not statistically significant (P = .19).ConclusionsIn pediatric patients, preoperative portosystemic shunts are significantly correlated with portal venous complications, some of which require minimal interventions after LDLT with good outcomes. Shunts larger than 3.35 mm tend to persist after transplant with increased portal venous complications. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
