Surgical complications and outcome of pediatric liver transplantation in Hong Kong.
OBJECTIVE
The aim of this study was to analyze the early and late results of pediatric liver transplantation, with particular reference to complications that required surgical or radiologic intervention.


METHODS
The records and code sheets of children who underwent liver transplantation in the authors' institution between September 1993 and December 2001 were reviewed.


RESULTS
Twenty-nine children (16 boys and 13 girls) underwent 31 liver transplantations (23 living donor, 8 cadaveric donor) during the study period. The ages of the children ranged from 4 months to 132 months (median, 16 months). Eighteen children had complications that required surgical or radiologic interventional procedures. Complications included, among others, hepatic vein thrombosis (n = 1, 3%), hepatic vein stenosis (n = 2, 7%), portal vein thrombosis (n = 2, 7%), biliary stricture (n = 3, 10%), bile leakage (n = 2, 7%), hepatic artery pseudoaneurysm (n = 1, 3%), jejuno-jejunostomy leakage (n = 1, 3%), graft hepatitis (n = 1, 3%), and posttransplant lymphoproliferative disorder (n = 2, 7%). In addition, 6 children (21%) suffered from intraabdominal bleeding from a variety of causes. After appropriate interventions, at a median follow-up of 38 months (range, 1 to 96 months), patient and graft survival rates were 79% and 74%, respectively. The retransplantation rate was only 7%. There was no incidence of hepatic artery thrombosis. All living donors remain alive and well.


CONCLUSIONS
Complications are inevitable in pediatric liver transplantation. However, with timely recognition and active intervention, a good outcome can be achieved.
Saing
H
H
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Fan
S T
ST
Tam
P K H
PK
Lo
C M
CM
Wei
W I
WI
Chan
K L
KL
Tsoi
N S
NS
Yuen
K Y
KY
Ng
I O L
IO
Chau
M T
MT
Tso
W K
WK
Wong
J
J
D002648:Child; D002675:Child, Preschool; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007431:Intraoperative Complications / Q000453:epidemiology*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D015996:Survival Rate; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome