Bowel perforation after pediatric living donor liver transplantation.
OBJECTIVE
Bowel perforation after liver transplantation (LT) is a rare, but highly lethal complication with a poor prognosis. Here, we report the outcome of cases of bowel perforation after pediatric LT in our department.


METHODS
The study subjects were 148 patients who underwent pediatric living donor liver transplantation. The 114 with biliary atresia (BA) were divided into two groups: those with associated bowel perforation (Group A) and those without (Group B).


RESULTS
Four patients in all (2.5%) suffered bowel perforation. Their original disease was BA and emergency surgery was performed in all cases, with a mortality rate of 50.0%. Comparison of Groups A and B revealed significant differences in the patient age, body weight, duration of surgery, cold ischemic time, and blood loss volume. The survival rates in Groups A and B were 50.0 and 99.1%, respectively (p < 0.01). Duration of surgery was an independent risk factor (p = 0.05).


CONCLUSIONS
Bowel perforation after LT is a potentially fatal complication. LT is a procedure that requires care and precision, and the possibility of bowel perforation should always be borne in mind during post-operative management, when the duration of surgery has been long.
Sanada
Yukihiro
Y
Department of Transplant Surgery, Jichi Medical University, Tochigi, 329-0498, Japan. yuki371@jichi.ac.jp
Mizuta
Koichi
K
Wakiya
Taiichi
T
Umehara
Minoru
M
Egami
Satoshi
S
Urahashi
Taizen
T
Hishikawa
Shuji
S
Fujiwara
Takehito
T
Sakuma
Yasunaru
Y
Hyodo
Masanobu
M
Yasuda
Yoshikazu
Y
Kawarasaki
Hideo
H
D000293:Adolescent; D000328:Adult; D001656:Biliary Atresia / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D015984:Causality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000209:etiology; D007564:Japan / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult