Factors and outcomes of lymphatic leakage after pediatric liver transplantation
10.3760/cma.j.cn421203-20210309-00092
- VernacularTitle:儿童肝移植术后淋巴漏的影响因素及预后
- Author:
Tao CUI
1
;
Chao SUN
;
Chong DONG
;
Kai WANG
;
Hong QIN
;
Chao HAN
;
Yang YANG
;
Fubo ZHANG
;
Wei GAO
Author Information
1. 天津医科大学一中心临床学院 300070
- Keywords:
Liver transplantation;
Lymphatic leakage;
Child
- From:
Chinese Journal of Organ Transplantation
2021;42(10):577-581
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the incidence of lymphatic leakage after pediatric liver transplantation and explore the diagnosis and treatment of lymphatic leakage.Methods:From January 1, 2016 to December 31, 2019, clinical data were analyzed retrospectively for 805 pediatric liver transplant recipients. Based upon the diagnosis of lymphatic leakage, they were divided into two groups of lymphatic leakage ( n=271) and lymphatic non-leakage ( n=534). Analyzing the incidence of lymphatic leakage after liver transplantation in children, evaluating the treatment plan, comparing survival rate and the incidence of postoperative complications between two groups. Results:The incidence of lymphatic leakage was 33.7%(271/805); the proportion of partial liver donors was 14.8% in lymphatic leakage group and 25.8% in lymphatic non-leakage group ( P<0.001). Other basic profiles of two groups were not statistically different. The median follow-up period was 32 months in lymphatic leakage group and 30.6 months in lymphatic non-leakage group. No significant inter-group difference existed in cumulative survival rate, vascular complications, bile leakage, acute cell rejection or intestinal obstruction. The area-under-curve (AUC) of ascites to serum triglyceride (TG) ratio for predicting lymphatic leakage was 0.741, optimal cut-off value 0.54, sensitivity 59.2% and specificity 80.1%. Conclusions:Lymphatic leakage is a common complication after liver transplantation in children. With no significant correlation with the morbidity or mortality, it prolongs postoperative hospital stay. The ratio of ascites to serum TG may be utilized as an effective reference index for diagnosing lymphatic leakage. And lymphatic leakage can be improved by taking a low-fat diet.
