[Technique to minimize the incidence of hepatic artery thrombosis in pediatric liver transplantation].
Hepatic artery thrombosis is a life-threatening complication after pediatric liver transplantation. We reviewed our experience in 62 children who received 72 liver transplant (69 whole grafts and 3 reduced-size grafts) between January 1984 and December 1991. They ranged in age from 6 months to 16 years (mean 5.8 years). Fifteen children (22%) were under 2 years and 10 patients (14%) were between 2 and 5 years. Forty-eight grafts in older children (age: 1-16 years, x = 7 years had an anastomosis between the donor hepatic/celiac artery and the recipient hepatic of splenic artery (A-A). Three thromboses occurred in this group for an incidence of 6.2%. Two others types of arterial reconstruction were used in 24 children who were significantly younger (6-120 months, x = 47 months, p < 0.01). Eight grafts had an anastomosis between the donor celiac artery and the recipient aorta (A-Ao). No thromboses occurred in this group. Sixteen grafts were revascularized using a donor aortic conduit anastomosed to the recipient aorta (AC) with a 12.5% (2 to 16) incidence of thrombosis. The incidence of arterial thrombosis for the entire group was 6.9%. In conclusion, by using the recipient aorta for arterial reconstruction, a low incidence of hepatic artery thrombosis can be achieved even in the group of younger patients who are the highest risk for this complication.
Roy
A
A
Département de chirurgie Hépato-bilaire et Pancréatique, Hôpital Saint-Luc, Université de Montréal, Québec, Canada.
McAlister
V
V
Grant
D R
DR
Lapointe
R
R
Dagenais
M
M
Wall
W J
WJ
D000293:Adolescent; D000367:Age Factors; D001656:Biliary Atresia / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006499:Hepatic Artery; D006521:Hepatitis, Chronic / Q000601:surgery; D006801:Humans; D015994:Incidence; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D013927:Thrombosis / Q000453:epidemiology* / Q000209:etiology
Technique afin de minimiser l'incidence de la thrombose de l'artère hépatique en transplantation hépatique pédiatrique.