This study showed that haemangiomas were likely to be diagnosed correctly, but other tumours and vascular malformations were likely to be misdiagnosed. Misdiagnosis seldom led to improper treatment, but probably led to delayed treatment in many cases. The interdisciplinary approach led to improved diagnostics and treatment.

Central venous access devices (CVADs) are often required in children with haemophilia to secure venous access for prophylactic treatment or immune tolerance therapy. Complications of CVADs include infections, thrombosis and mechanical problems. This study sought to determine the outcome of the vessels by magnetic resonance imaging (MRI) in children with haemophilia and to assess risk factors for development of catheter-related deep venous thrombosis (DVT). After the removal of CVAD an MRI of the chest and neck was performed to 20 boys with haemophilia who each had 1-3 (total number 27) CVADs placed. MRI revealed DVT in five children (25%). As their CVADs were functional at the time of the removal, the DVTs were clinically silent. However, there had been suspicion of DVT leading to replacement of the CVAD in one case. All the children with DVT had their CVADs inserted initially below the age of 1 year. The clinical signs of mild post-thrombotic syndrome (PTS) were common: dilated chest wall veins were observed in 11 (55%) children and were associated with DVT in three cases. Arm circumference discrepancy was observed in one child with DVT. No correlation between the duration or number of CVADs and DVT was detected. None of the patients had subjective symptoms of PTS. Silent DVT is a common complication of CVAD. Catheter insertion at a young age seems to predispose to thrombosis. The long-term consequences of the DVTs remain unknown.

Hepatic artery thrombosis (HAT) after liver transplantation (LT) increases patient morbidity and mortality. Early HAT is considered to occur within the first month after LT, whereas late HAT occurs after the first month. Few studies have addressed late HAT after LT, especially in pediatric patients. Between 1987 and 2007, 99 patients (age < 18 years) underwent deceased donor LT. Thirty-four of 66 eligible patients (52%) underwent magnetic resonance imaging (MRI) according to protocol. On the basis of MRI findings, the patients were grouped as those who experienced late HAT and those who did not. Additionally, potential risk factors for late HAT were analyzed retrospectively. P values were adjusted for multiplicity. The median age at LT was 1.7 years [interquartile range (IQR) 5 1.0-9.6 years], and the median follow-up time at MRI was 9.5 years (IQR 5 4.0-16.4 years). Late HAT was diagnosed in 15 of the 34 patients [44%, 95% confidence interval (CI) 5 29%-61%] undergoing MRI and in 3 of these patients with angiography preceding MRI. Ultrasonography revealed late HAT in 6 of these 15 patients with a sensitivity of 40% (95% CI 5 20%-64%). The donor/recipient weight ratio remained significantly higher for the patients with late HAT versus the patients without late HAT after P values were adjusted (5.4 versus 1.9, P 5 0.03). No marked differences were observed in laboratory or liver histology parameters between the groups. In conclusion, late HAT is common after pediatric LT. The donor/recipient weight ratio was higher for patients with late HAT, and this was attributable to the lower weight of the recipients. No salient features of late HAT were observed with respect to laboratory or histological parameters, at least in terms of our study's cross-sectional period. Liver Transpl 20:591-600, 2014. V C 2014 AASLD.Received October 22, 2013; accepted January 30, 2014. See Editorial on Page 512Vascular complications after liver transplantation (LT) decrease both graft and patient survival.1 Hepatic artery thrombosis (HAT) is a major cause of retransplantation in the pediatric population.2 Early and late forms of HAT have been described, but the exact time interval for these 2 forms has not been established. However, most studies define early HAT as occurring within the first month after LT. 3The incidence of early HAT is higher in pediatric patients versus adult patients, and risk factors for early HAT have been proposed even in a contradictory manner.3 For example, in the setting of pediatric LT,