Perioperative Thrombotic Complications Associated with Pediatric Liver Transplantation: a UNOS Database Evaluation

Overview

Journal HPB (Oxford)

Publisher Elsevier

Specialty Gastroenterology

Date 2018 Sep 30

PMID 30266497

Citations 4

Authors

Dmitri Bezinover

Molly F Deacutis

Priti G Dalal

Robert P Moore

Jonathan G Stine

Ming Wang

Ethan Reeder

Christopher S Hollenbeak

Fuat H Saner

Thomas R Riley 3rd

Piotr K Janicki

Affiliations

Soon will be listed here.

Abstract

Background: This retrospective UNOS database evaluation analyzes the prevalence of preoperative portal vein thromboses (PVT), and postoperative thromboses leading to graft failure in pediatric patients undergoing liver transplantation (LT).

Methods: The evaluation was performed in three age groups: I (0-5), II (6-11), III (12-18) years old. Factors predictive of pre- and postoperative thromboses were analyzed.

Results: Between 2000 and 2015, 8982 pediatric LT were performed in the US. Of those, 390 patients had preoperative PVT (4.3%), and 396 (4.4%) had postoperative thromboses. The prevalence of both types of thromboses was less in Group III than in the other two groups (3.20% vs 4.65%, p = 0.007 and 1.73% vs. 5.13%, p < 0.001, respectively). The prevalence of postoperative thromboses was significantly higher in Group I than in the other two groups (5.49% vs. 2.51%, p < 0.001). Preoperative PVT was independently associated with postoperative thromboses (OR = 1.7, p = 0.02). Children less than 5 years of age were more likely to develop postoperative thromboses leading to graft failure (OR = 2.9, p < 0.001).

Conclusion: Younger children undergoing LT are prone to pre-and postoperative thrombotic complications. Preoperative PVT at the time of transplantation was independently associated with postoperative thromboses. Perioperative antithrombotic therapy should be considered in pediatric patients undergoing LT.

Citing Articles

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Current Endovascular Management of Arterial Complications After Pediatric Liver Transplantation in a Tertiary Center.

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Hyponatremia Is Associated With Increased Mortality in Children on the Waiting List for Liver Transplantation.

Bezinover D, Nahouraii L, Sviatchenko A, Wang M, Kimatian S, Saner F Transplant Direct. 2020; 6(10):e604.

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Hyponatremia Is Protective Against the Development of Portal Vein Thrombosis in Patients Undergoing Liver Transplant.

Bezinover D, Navabi S, Wang M, Li Z, William M, Stine J Transplant Proc. 2019; 51(6):1880-1886.

PMID: 31399172 PMC: 7485064. DOI: 10.1016/j.transproceed.2019.05.014.

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