Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Clin Transplant. 2010 Jul-Aug;24(4):550-6. doi: 10.1111/j.1399-0012.2009.01123.x.
Portal vein (PV) complications in pediatric living donor liver transplantation (LDLT) are often asymptomatic in the early stages after transplantation and can be serious enough to lead to graft failure. There have been few reports on risk factors for PV complications in LDLT. The aim of this study is to investigate the influence of hepatic inflow upon PV complications and to predict patients at risk for these complications.
MATERIAL/METHOD: From 1997 to 2008, 46 pediatric patients underwent LDLT at our center. Portal venous and hepatic arterial flows and PV diameter were analyzed.
PV complications were identified in seven patients (15.2%) and occurred at a younger age and lower weight. As a result of appropriate treatment, none of the patients suffered graft failure. Analysis of the 46 patients and 27 patients under two yr of age identified smaller PV diameter in recipient and larger discrepancy of PV diameter as risk factors. Portal venous flow tended to be low, in contrast to hepatic arterial flow, which tended to be high.
PV size strongly influences PV complications. Other factors such as younger age, low portal venous flow, and high hepatic arterial flow may be risk factors for PV complications.
在小儿活体肝移植（LDLT）术后早期，门静脉（PV）并发症常无症状，但严重者可导致移植物失功。PV 并发症的危险因素少有报道。本研究旨在探讨肝流入对 PV 并发症的影响，并预测发生这些并发症的高危患者。
材料/方法：1997 年至 2008 年，本中心 46 例小儿接受 LDLT。分析门静脉和肝动脉血流及 PV 直径。
7 例（15.2%）发生 PV 并发症，发病年龄更小，体重更轻。经适当治疗，无患者发生移植物失功。对 46 例患者和 27 例 2 岁以下患者的分析显示，受体 PV 直径较小和 PV 直径差异较大是危险因素。门静脉血流倾向于低，而肝动脉血流倾向于高。
PV 大小强烈影响 PV 并发症。其他因素如年龄较小、门静脉血流低和肝动脉血流高可能是 PV 并发症的危险因素。
