Rare complication after pediatric living donor liver transplantation: right diaphragmatic hernia
10.3969/j.issn.1674-7445.2020.04.006
- VernacularTitle:儿童活体肝移植术后罕见并发症——右侧膈疝
- Author:
Wei QU
1
;
Zhijun ZHU
;
Lin WEI
;
Liying SUN
;
Zhigui ZENG
;
Ying LIU
;
Jun WANG
;
Yule TAN
;
Liang ZHANG
;
Enhui HE
Author Information
1. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Publication Type:Research Article
- Keywords:
Pediatric liver transplantation;
Living donor liver transplantation;
Diaphragmatic hernia;
Biliary atresia;
Alkaline phosphatase;
Portal hypertension;
Bile leakage
- From:
Organ Transplantation
2020;11(4):461-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics, pathogenic causes and therapeutic experience of right diaphragmatic hernia after pediatric living donor liver transplantation. Methods Clinical data of 3 recipients with right diaphragmatic hernia after pediatric living donor liver transplantation were retrospectively analyzed. The clinical characteristics, diagnosis and treatment process and therapeutic experience were analyzed and summarized. Results The primary diseases of 3 children with diaphragmatic hernia after living donor liver transplantation were biliary atresia. The diaphragmatic hernia occurred at 4-6 months after liver transplantation. The contents of diaphragmatic hernia included the intraperitoneal and interperitoneal tissues and organs. Diaphragmatic defects were all located in the posterior medial area of the right diaphragm. The primary stage intermittently suturing repair was performed during intraoperative period. No diaphragmatic hernia recurred during long-term follow-up. Conclusions The clinical manifestations of right diaphragmatic hernia after pediatric living donor liver transplantation are diverse. The risk factors include malnutrition, low body weight, surgical trauma, chemical erosion caused by bile leakage, focal infection and pleural-peritoneal pressure gradient, etc. Surgical intervention is the preferred treatment strategy for diaphragmatic hernia after liver transplantation.