Document Detail


Risk factors for intraoperative portal vein thrombosis in pediatric living donor liver transplantation.
MedLine Citation:
PMID:  15233815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pathologic changes of the recipient native portal venous system may cause thrombosis of the portal vein, especially in pediatric living donor liver transplantation (LDLT). This study assessed the utility of Doppler ultrasound (US) for the detection of intraoperative portal vein occlusion and identification of predisposing risk factors in the recipients. Seventy-three pediatric recipients who underwent LDLT at Chang Gung Memorial Hospital, Taiwan, from 1994 to 2002 were included. Preoperative and intraoperative Doppler US evaluation of the portal vein was performed. Age, body weight, native liver disease, type of graft, graft recipient weight ratio (GRWR), type of portal anastomosis, portal velocity, portal venous size and presence of portosystemic shunt were analyzed for statistical significance of predisposing risk factors. Eight episodes of intraoperative portal vein thrombosis, with typical findings of absent Doppler flow in portal vein and prominent hepatic artery with a resistant index lower than 0.5 (p < 0.001), were detected during transplantation, which was then corrected by thrombectomy and re-anastomosis. Children age < or =1 yr (p = 0.025), weight < or =10 kg (p = 0.024), low portal flow < or =7 cm/s (p = 0.021), portal venous size < or =4 mm (p = 0.001), and GRWR >3 (p < 0.017) were all risk factors for intraoperative portal vein thrombosis. Doppler US is essential in the preoperative evaluation, early detection and monitoring of outcome of the portal vein in liver transplant.
Authors:
Yu Fan Cheng; Chao Long Chen; Tung Liang Huang; Tai Yi Chen; Yaw Sen Chen; Mitsuhisa Takatsuki; Chih Chi Wang; King Wah Chiu; Leo Leung-chit Tsang; Po Lin Sun; Bruno Jawan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical transplantation     Volume:  18     ISSN:  0902-0063     ISO Abbreviation:  Clin Transplant     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-05     Completed Date:  2004-10-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  390-4     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, Chang Gung, University, Chang Gung Memorial Hospital, Kaohsiumg Medical Center, Koahsiung, Taiwan. cheng.yufen@msa.hinet.net
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Flow Velocity
Child
Child, Preschool
Female
Humans
Infant
Intraoperative Complications / epidemiology*,  ultrasonography
Liver Transplantation / adverse effects*
Living Donors
Male
Portal Vein*
Risk Factors
Thrombectomy
Ultrasonography, Doppler
Vascular Resistance
Venous Thrombosis / epidemiology*,  surgery,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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