Lowering the incidence of complications of portal vein through vascular graft interposition during pediatric transplantation
10.3760/cma.j.cn421203-20200820-00302
- VernacularTitle:间置血管重建门静脉对儿童肝移植受者术后门静脉并发症的影响
- Author:
Xiaojie CHEN
1
;
Zhijun ZHU
;
Liying SUN
;
Haiming ZHANG
;
Lin WEI
;
Wei QU
;
Zhigui ZENG
;
Ying LIU
;
Jinping ZHANG
Author Information
1. 首都医科大学附属北京友谊医院普外科肝脏移植中心 国家消化系统疾病临床医学研究中心 首都医科大学儿童肝脏移植临床诊疗与研究中心 100050
- Keywords:
Liver transplantation;
Portal vein;
Child
- From:
Chinese Journal of Organ Transplantation
2021;42(10):587-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility of using vascular graft interposition for lowering the complications of portal vein during pediatric liver transplantation.Methods:From June 1, 2013 to May 31, 2018, clinical data were collected for 297 children undergoing liver transplantation, including basic demographics, general preoperative status, preoperative tests, imaging findings, graft related profiles, surgical procedures and postoperative follow-ups, etc. Then the authors analyzed the effect of using interposition vessels upon lowering postoperative complications of portal vein reconstruction.Results:With a median age of 12 months, there were 153 boys (51.5%) and 144 girls (48.5%). The primary disease was mostly biliary atresia ( n=222, 74.7%). The median diameter of portal vein was 5 mm. There were 19 cases (6.4%) using vascular interposition. Among 20 cases of portal vein complications, there were portal vein stenosis ( n=17, 5.7%) and portal vein thrombosis ( n=3, 1.0%). After univariate analysis, binary Logistic regression analysis revealed that diameter of recipient's portal vein was an independent risk factor for the occurrence of portal vein complications after liver transplantation. Statistical analysis of children with portal vein diameter <4 mm ( n=90) was carried on and the results showed that there was no inter-group statistical difference ( χ2=3.061, P=0.080)on the occurrence of portal vein complications. Conclusions:Diameter of portal vein is an important factor affecting the strategic choice of portal vein reconstruction during pediatric liver transplantation and an independent risk factor for portal vein complications after liver transplantation. When the diameter of portal vein is ≤4 mm, using interposition vascular anastomosis shows no significant difference with other conventional modes.
