title: Endovascular interventions for hepatic artery complications immediately after pediatric liver transplantation.
abstract: Hepatic artery complications after living donor liver transplantation (LDLT) can directly affect both graft and recipient outcomes. For this reason, early diagnosis and treatment are essential. In the past, relaparotomy was generally employed to treat them. Following recent advances in interventional radiology, favorable outcomes have been reported with endovascular treatment. However, there is ongoing discussion regarding the best and safe time for definitive endovascular interventions. We herein report a retrospective analysis for six children with early hepatic artery complication after pediatric LDLT who underwent endovascular treatment as primary therapy at our institution. We evaluate the usefulness of endovascular treatment for hepatic artery complication and its optimal timing. The mean patient age was 11.9 months and mean body weight at LDLT was 6.7 kg. The mean duration between the transplantation and first endovascular treatment was 5.3 days. Five of the six patients were technically successful treated by only endovascular treatment. Of these five patients, two developed biliary complications. Endovascular procedures were performed 10 times in six patients without any complications and nine of the 10 procedures were successful. By selecting optimal devices, our findings suggest that endovascular treatment can be feasible and safe in the earliest time period after pediatric LDLT.
authors.affiliation: Department of Transplant Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan. wakiya@jichi.ac.jp
authors.forename: Taiichi
authors.initials: T
authors.lastname: Wakiya
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Sanada
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizuta
authors.forename: Minoru
authors.initials: M
authors.lastname: Umehara
authors.forename: Taizen
authors.initials: T
authors.lastname: Urahashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Egami
authors.forename: Shuji
authors.initials: S
authors.lastname: Hishikawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Nakata
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hakamada
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Hideo
authors.initials: H
authors.lastname: Kawarasaki
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D001835:Body Weight; D002675:Child, Preschool; D017985:Dalteparin / Q000494:pharmacology; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006499:Hepatic Artery / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods
chemical_list: D000925:Anticoagulants; D017985:Dalteparin