Efficacy of intraoperative cine-portogram for complicated portal vein reconstruction in pediatric living donor liver transplantation.
Child
Child, Preschool
Cineangiography
Collateral Circulation
Female
Follow-Up Studies
Humans
Infant
Intraoperative Care
/ methods
Liver Transplantation
/ methods
Living Donors
Male
Outcome Assessment, Health Care
Portal Vein
/ diagnostic imaging
Retrospective Studies
Ultrasonography, Doppler
Venous Insufficiency
/ diagnostic imaging
Venous Thrombosis
/ diagnostic imaging
pediatric liver transplantation
portography
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
26
02
2020
revised:
01
07
2020
accepted:
08
08
2020
pubmed:
5
9
2020
medline:
5
1
2022
entrez:
5
9
2020
Statut:
ppublish
Résumé
Sufficient PV flow is necessary to achieve successful PV reconstruction in pediatric LDLT. IOCP can be used to assess the severity of PV stenosis and to identify potential portosystemic collateral pathways. The present study reviewed the utility of IOCP and the outcomes of patients who underwent assessment with an IOCP. Consecutive primary LDLTs were performed in 488 pediatric recipients between November 2005 and October 2019. IOCP was used in patients who were unable to achieve sufficient PV flow after the ligation of collaterals. In total, 11 patients underwent IOCP to assess potential portosystemic collateral pathways. The median age and body weight was 8 months (IQR, 6-11 months) and 6.6 kg (IQR, 5.7-8.9 kg), respectively. The reasons for using the IOCP were recurrent PV thrombus in seven patients and insufficient PV flow in four patients. IOCP revealed remaining collaterals in six patients and residual hypoplastic PV in eight patients. Two patients required additional interruption of the potential collaterals under IOCP, which were unable to be recognized as a dominant portosystemic collateral pathway on preoperative imaging. All eight patients with residual hypoplastic PV required vein graft interposition for the complete removal of the hypoplastic PV. All the patients are currently doing well with a median follow-up period of 4.9 years (IQR, 2.2-5.6 years). IOCP can be an effective tool for precisely detecting occult portosystemic collateral pathways and for assessing the patency of the PV anastomosis in pediatric LDLT.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13835Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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