Risk factors and treatments of portal vein thrombosis after pediatric living donor liver transplantation
10.3760/cma.j.cn421203-20240403-00080
- VernacularTitle:儿童活体肝移植术后门静脉血栓的危险因素及处理
- Author:
Ganlin CUI
1
;
Chong DONG
;
Chao SUN
;
Kai WANG
;
Weiping ZHENG
;
Yang YANG
;
Zhen WANG
;
Xinzhe WEI
;
Linxiao LI
;
Weihan LI
;
Wei GAO
Author Information
1. 天津医科大学第一中心临床学院，天津 300270
- Keywords:
Liver transplantation;
Pediatric;
Portal vein thrombosis
- From:
Chinese Journal of Organ Transplantation
2024;45(11):788-795
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors and treatments of portal vein thrombosis (PVT) in children after pediatric living donor liver transplantation (pLDLT) .Method:From January 2014 to December 2021, the relevant clinical data were retrospectively reviewed for 975 LDLT children at Department of Pediatric Organ Transplantation of Tianjin First Central Hospital. Based upon the postoperative occurrence of PVT, they were assigned into two groups of PVT (19 cases) and non-PVT (956 cases). Univariate and multivariate analyses were performed for screening the risk factors of PVT post-LDLT and discussing the managements and prognoses of PVT.Result:Among them, overall incidence of PVT post-LDLT was 1.9% (19/975), and median time for an initial occurrence of PVT 8 (1-495) day. Single-factor analysis indicated that donor height ( P=0.014), operative duration ( P=0.002) and vascular interposition ( P=0.001) were correlated with the occurrence of postoperative PVT post-pLDLT. Multifactorial analysis revealed that operative duration ( P=0.008) and vascular interposition ( P<0.01) were independent risk factors for PVT post-pLDLT. For 19 cases of postoperative PVT, the measures included surgical thrombectomy (8 cases), urokinase thrombolysis plus warfarin anticoagulation (3 cases), interventional treatment (3 cases), warfarin anticoagulation (4 cases) and retransplantation (1 cases). After treatment, the outcomes were a disappearance of PVT (15 cases), symptomatic improvement (2 cases) and unrelated mortality (2 cases) . Conclusion:During pLDLT, intraoperative placement of blood vessels and operative duration are independent risk factors for the occurrence of PVT. Timely standardized treatment may achieve satisfactory therapeutic outcomes.
