Vascular Complications After Pediatric Liver Transplantation From the Living Donors

Broniszczak, Dorota; Szymczak, Marek; Kamiński, Andrzej; Chyżyńska, A.; Ismail, Hor; Drewniak, Tomasz; Nachulewicz, Paweł; Markiewicz, M; Teisseyre, Joanna; Dzik, E.; Lembas, Agnieszka; Kaliciński, Piotr

doi:10.1016/j.transproceed.2006.02.094

Cited by 42 publications

(41 citation statements)

References 14 publications

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“…Figure 1 (12,28,42,51,52,71,73,76,77) for the arterial anastomosis (3.1%) versus centers using loupe magnification (2.1%, p = 0.6) (25,37,53,54,74).…”

Section: Results Of the Search Strategymentioning

confidence: 99%

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Early Hepatic Artery Thrombosis after Liver Transplantation: A Systematic Review of the Incidence, Outcome and Risk Factors

Bekker¹,

Ploem

Jong³

2009

American Journal of Transplantation

504

507

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To clarify inconsistencies in the literature we performed a systematic review to identify the incidence, risk factors and outcome of early hepatic artery thrombosis (eHAT) after liver transplantation. We searched studies identified from databases (MEDLINE, EMBASE, Science Citation Index) and references of identified studies. Seventy-one studies out of 999 screened abstracts were eligible for this systematic review. The incidence of eHAT was 4.4% (843/21, 822); in children 8.3% and 2.9% in adults (p < 0.001). Doppler ultrasound screening (DUS) protocols varied from 'no routine' to 'three times a day.' The median time to detection was at day seven. The overall retransplantation rate was 53.1% and was higher in children (61.9%) than in adults (50%, p < 0.03). The overall mortality rate of patients with eHAT was 33.3% (range: 0-80%). Mortality in adults (34.3%) was higher than in children (25%, p < 0.03). The reported risk factors for eHAT were, cytomegalovirus mismatch (seropositive donor liver in seronegative recipient), retransplantation, arterial conduits, prolonged operation time, low recipient weight, variant arterial anatomy, and low volume transplantation centers. eHAT is associated with significant graft loss and mortality. Uniform definitions of eHAT and uniform treatment modalities are obligatory to confirm these results and to obtain a better understanding of this disastrous complication.

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“…Figure 1 (12,28,42,51,52,71,73,76,77) for the arterial anastomosis (3.1%) versus centers using loupe magnification (2.1%, p = 0.6) (25,37,53,54,74).…”

Section: Results Of the Search Strategymentioning

confidence: 99%

“…In only two centers routine DUS was not performed (3,46 (12,27,28,33,42,44,48,51,52,54,62,65,71,84 (12,16,17,21,25,27,28,33,35,(41)(42)(43)(45)(46)(47)(48)(53)(54)(55)57,59,67,(70)(71)(72)(73)80,82,(84)(85)(86)(87) (12,27,28,33,42,…”

Section: Doppler Ultrasound Screening Protocolsmentioning

confidence: 99%

Early Hepatic Artery Thrombosis after Liver Transplantation: A Systematic Review of the Incidence, Outcome and Risk Factors

Bekker¹,

Ploem

Jong³

2009

American Journal of Transplantation

504

507

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“…However, arterial occlusion resulting in graft loss is a fatal complication and surgical management does not succeed in some cases. 14,15 Therefore, thrombolysis was performed despite the possibility of bleeding complications. Bleeding complications following thrombolysis can be managed by TAE or surgical ligation.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of acute arterial complications after living-donor liver transplantation

et al. 2008

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“…Early thrombotic events occur within 30 days of transplantation and relate specifically to the anatomic and pathophysiologic disruption at the time of vascular reconstruction and throughout the subsequent period of graft recovery. Reported rates of these complications vary widely between centers, ranging from < 2% to more than 10% of transplants for both HAT and PVT [9,10,[13][14][15][16][17][18][19][20][21][22]. This apparent wide variability is supported by US registry data and most likely reflects differences in recipient risk factors (e.g., age, weight, underlying diagnosis, and comorbidities), surgical techniques, expertise, and perioperative thrombosis prevention strategies [23].…”

Section: Pathophysiologymentioning

confidence: 99%

Pediatric transplantation: preventing thrombosis

Robertson

2015

Journal of Thrombosis and Haemostasis

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Summary Due to progressive advances in surgical techniques, immunosuppressive therapies, and supportive care, outcomes from both solid organ transplantation and hematopoietic stem cell transplantation continue to improve. Thrombosis remains a challenging management issue in this context, with implications for both graft survival and long‐term quality of life. Unfortunately, there remains a general paucity of pediatric‐specific data regarding thrombosis incidence, risk stratification, and the safety or efficacy of preventative strategies with which to guide treatment algorithms. This review summarizes the available evidence and rationale underlying the spectrum of current practices aimed at preventing thrombosis in the transplant recipient, with a particular focus on risk factors, pathophysiology, and described antithrombotic regimens.

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Vascular Complications After Pediatric Liver Transplantation From the Living Donors

Cited by 42 publications

References 14 publications

Early Hepatic Artery Thrombosis after Liver Transplantation: A Systematic Review of the Incidence, Outcome and Risk Factors

Early Hepatic Artery Thrombosis after Liver Transplantation: A Systematic Review of the Incidence, Outcome and Risk Factors

Endovascular treatment of acute arterial complications after living-donor liver transplantation

Pediatric transplantation: preventing thrombosis

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