Orlandini Mariana, Feier Flávia Heinz, Jaeger Brunna, Kieling Carlos, Vieira Sandra Gonçalves, Zanotelli Maria Lucia
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Pediatric Liver Transplantation Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
J Pediatr (Rio J). 2014 Mar-Apr;90(2):169-75. doi: 10.1016/j.jped.2013.08.010. Epub 2013 Dec 24.
to evaluate the frequency and factors associated with vascular complications after pediatric liver transplantation.
risk factors were evaluated in 99 patients under 18 years of age with chronic liver disease who underwent deceased donor liver transplantation (DDLT) between March of 1995 and November of 2009 at the Hospital de Clínicas de Porto Alegre, Brazil. The variables analyzed included donor and recipient age, gender, and weight; indication for transplant; PELD/MELD scores; technical aspects; postoperative vascular complications; and survival.
vascular complications occurred in 19 patients (19%). Arterial events were most common, occurred earlier in the postoperative period, and were associated with high graft loss and mortality rates. In the multivariate analysis, the following factors were identified: portal vein diameter ≤ 3mm, donor-to-recipient body weight ratio (DRWR), prolonged ischemic time, and use of arterial grafts.
the choice of treatment depends on the timing of diagnosis; however, in this study, surgical revision or correction produced worse outcomes than percutaneous angioplasty. The reduction of risk factors and early detection of vascular complications are key elements to a successful transplantation.
评估小儿肝移植术后血管并发症的发生率及相关因素。
对1995年3月至2009年11月在巴西阿雷格里港临床医院接受尸体供肝肝移植（DDLT）的99例18岁以下慢性肝病患者的危险因素进行评估。分析的变量包括供体和受体的年龄、性别和体重；移植指征；PELD/MELD评分；技术方面；术后血管并发症；以及生存率。
19例患者（19%）发生血管并发症。动脉事件最为常见，在术后早期发生，且与高移植肝丢失率和死亡率相关。多因素分析确定了以下因素：门静脉直径≤3mm、供受体体重比（DRWR）、缺血时间延长和使用动脉移植物。
治疗方法的选择取决于诊断时机；然而，在本研究中，手术修复或矫正的结果比经皮血管成形术更差。降低危险因素和早期发现血管并发症是移植成功的关键因素。
