Pediatric liver transplantation:clinical analysis of 88 cases
10.3877/cma.j.issn.2095-3232.2015.05.006
- VernacularTitle:儿童肝移植88例临床分析
- Author:
Shuguang JIN
1
;
Wentao WANG
;
Bo XIANG
;
Jiayin YANG
;
Wei LAI
;
Lyunan YAN
Author Information
1. 610041成都,四川大学华西医院小儿外科
- Keywords:
Child;
Liver transplantation;
Postoperative complications;
Survival rate
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2016;5(5):295-299
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo summarize the operative experiences and postoperative complications of pediatric liver transplantation (LT).MethodsClinical data of 88 child patients undergoing LT in West China Hospital, Sichuan University between January 2000 and October 2015 were retrospectively analyzed. Among the patients, 38 were males and 50 were females, with the age ranging from 3 months to 17 years and 7 months old and the median of 2 years and 3 months old. Seventy-seven cases underwent living donor LT and 11 underwent cadaver LT. Thirty-nine cases underwent left lobe transplantation and 49 underwent left lateral lobe transplantation. The main immunosuppressive regimen after operation was adrenocortical hormone + tacrolimus (FK506) or cyclosporin. And heparin was used after operation for anticoagulation. The informed consents of all patients and their families were obtained and the local ethical committee approval was received. The intraoperative conditions and postoperative complications of the patients were observed.ResultsThe average operation time was (7.5±2.4) h, the median intraoperative blood loss was 475(100-2 000) ml, the transfusion of red blood cells was 1.8(0-6.5) U, the warm ischemia time was 2.5(1.0-10.0) min, the cold ischemia time was 188(110-590) min and the inferior vena cava occlusion time was 75(35-170) min. Forty-nine cases developed early complications after operation, and the incidence of vascular complications was 11%(10/88), including 4 cases of hepatic artery thrombosis, 5 of portal vein thrombosis and 1 of hepatic vein stenosis. Sixteen cases developed late complications, and the incidence of biliary complications was 12% (11/88), including 9 cases of cholangitis, 1 of bile leakage and 1 of bile duct stricture. The 1-, 3-year survival rate after LT was respectively 81% and 75%.Conclusions The success rate and postoperative survival rate of pediatric LT have increased signiifcantly in recent years. However, the incidence of postoperative vascular and biliary complications are still high. Thus, the operation procedures should be kept improving, and the immunosuppressant and anticoagulant therapy should be individually adjusted in order to obtain better efifcacy.
