Gastrointestinal bleeding after living-related liver transplantation.
We examined the prevalence of gastrointestinal bleeding in patients undergoing living-related liver transplantation (LRLT). Seventy-seven patients (37 male and 40 female) underwent LRLT at the University of Tokyo Hospital from January 1996 through December 1999. Forty-nine patients were children or adolescents and 28 patients were adults. The mean follow-up period was 21.3 +/- 12.8 months. Nine of the 77 recipients had gastrointestinal bleeding after transplantation. The incidence of posttransplant bleeding was significantly higher in adult recipients than in pediatric recipients (25% vs 4%, P < 0.05). The ratio of graft volume to standard liver volume was significantly lower in adult recipients than in pediatric recipients (41 +/- 6% vs 86 +/- 26%, P < 0.05). Portal vein thrombosis (PVT) developed after LRLT in 8 patients. Variceal bleeding subsequently occurred in all 4 adult patients with PVT but in only 1 of 4 pediatric patients. Small-for-size grafts may cause transient portal hypertension, which increases the risk of gastrointestinal bleeding.
Hirata
Masaru
M
Liver Transplantation Team, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Kita
Yoshiaki
Y
Harihara
Yasushi
Y
Hisatomi
Shinya
S
Sano
Keiji
K
Mizuta
Koichi
K
Yoshino
Hiroyuki
H
Sugawara
Yasuhiko
Y
Takayama
Tadatoshi
T
Kawarasaki
Hideo
H
Hashizume
Kohei
K
Makuuchi
Masatoshi
M
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D020246:Venous Thrombosis / Q000150:complications