Risk factors for early and late biliary complications in pediatric liver transplantation.

Détails

ID Serval
serval:BIB_05036ABE8593
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Risk factors for early and late biliary complications in pediatric liver transplantation.
Périodique
Pediatric Transplantation
Auteur(s)
Lüthold S.C., Kaseje N., Jannot A.S., Mentha G., Majno P., Toso C., Belli D.C., McLin V.A., Wildhaber B.E.
ISSN
1399-3046 (Electronic)
ISSN-L
1397-3142
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
18
Numéro
8
Pages
822-830
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish, pdf : Original Article
Résumé
BC are a common source of morbidity after pediatric LT. Knowledge about risk factors may help to reduce their incidence. Retrospective analysis of BC in 116 pediatric patients (123 LT) (single institution, 05/1990-12/2011, medium follow-up 7.9 yr). One-, five-, and 10-yr survival was 91.1%, no patient died of BC. Prevalence and risk factors for anastomotic and intrahepatic BC were examined. There were 29 BC in 123 LT (23.6%), with three main categories: 10 (8.1%) primary anastomotic strictures, eight (6.5%) anastomotic leaks, and three (2.4%) intrahepatic strictures. Significant risk factors for anastomotic leaks were total operation time (increase 1.26-fold) and early HAT (<30 days post-LT; increase 5.87-fold). Risk factor for primary anastomotic stricture was duct-to-duct choledochal anastomosis (increase 5.96-fold when compared to biliary-enteric anastomosis). Risk factors for intrahepatic strictures were donor age >48 yr (increase 1.09-fold) and MELD score >30 (increase 1.2-fold). To avoid morbidity from anastomotic BC in pediatric LT, the preferred biliary anastomosis appears to be biliary-enteric. Operation time should be kept to a minimum, and HAT must by all means be prevented. Children with a high MELD score or receiving livers from older donors are at increased risk for intrahepatic strictures.
Pubmed
Web of science
Création de la notice
21/02/2015 11:55
Dernière modification de la notice
20/08/2019 13:26
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