Postshunt encephalopathy in liver transplanted children with portal vein thrombosis.
BACKGROUND
Surgical portosystemic shunting has been reported to alleviate successfully portal hypertension in liver transplanted recipients with portal vein thrombosis.


METHODS
We report two liver transplanted children with portal vein thrombosis who developed post-shunt acute encephalopathy. In one child, a mesocaval H-type shunt was created surgically because of bleeding related to Roux-en-Y loop varices at 3 months posttransplantation; in the other, a large spontaneous splenorenal shunt was discovered at the time of diagnosis of portal vein thrombosis on day 34 posttransplantation and was preserved.


RESULTS
Post-shunt encephalopathy developed 6 months and 2.7 years after transplantation, causing death in one child.


CONCLUSIONS
This report illustrates the risk and the possible dismal outcome of post-shunt encephalopathy in liver transplanted children. Therapeutic procedures other than portosystemic shunting that will restore an hepatopetal portal flow to the liver graft should be considered in liver-transplanted children with portal vein thrombosis.
Tissières
P
P
Groupe de Transplantation Hépatique Pédiatrique, Assistance Publique, H pitaux de Paris, France.
Pariente
D
D
Chardot
C
C
Gauthier
F
F
Devictor
D
D
Debray
D
D
D001927:Brain Diseases / Q000150:complications / Q000209:etiology*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000150:complications*