Surgical complications after living donor liver transplantation in patients with biliary atresia: a relatively high incidence of portal vein complications.
OBJECTIVE
The aim of this study is to present the surgical complications in living donor liver transplantation (LDLT) for biliary atresia (BA) as a treatment for end stage liver disease.


METHODS
Twenty-nine LDLTs were performed in patients with BA between October 1996 and April 2008 in Department of Pediatric Surgery at Kyushu University Hospital. The initial immunosuppression was a combination of tacrolimus and steroids.


RESULTS
Twenty-eight of 29 cases with BA, who previously underwent Kasai's operation and LDLT was performed at a median age of 9.1 years (range 7 months to 28 years). Only one case was performed primary LDLT. Post-transplant complications included portal vein complications (n = 5), three of which successfully treated by Rex-shunt or ballooning. Others were bile leakage (n = 4), intestinal perforation (n = 4), and so on. The overall survival rate was 86.2% (25/29). One patient died of chronic rejection, surgical complications after LDLT in BA while others died of sepsis, multi-organ failure, and brain hemorrhage.


CONCLUSIONS
The incidence of portal vein complications and intestinal perforations was relatively high in LDLT for BA, possibly due to inflammation of the hepatoduodenal ligament and colonic adhesion to the liver. It is important to make an accurate diagnosis at an early stage and provide appropriate treatment.
Takahashi
Yukiko
Y
Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. takahashi-y@koseikan.jp
Nishimoto
Yuko
Y
Matsuura
Toshiharu
T
Hayashida
Makoto
M
Tajiri
Tatsuro
T
Soejima
Yuji
Y
Taketomi
Akinobu
A
Maehara
Yoshihiko
Y
Taguchi
Tomoaki
T
D000293:Adolescent; D000328:Adult; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000628:therapy; D001656:Biliary Atresia / Q000401:mortality / Q000601:surgery*; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D006084:Graft Rejection; D006499:Hepatic Artery; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000209:etiology / Q000628:therapy; D020300:Intracranial Hemorrhages / Q000401:mortality; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D011169:Portal Vein / Q000473:pathology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D018805:Sepsis / Q000401:mortality; D017131:Thrombectomy; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy; D055815:Young Adult