Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Liver Transplant Center, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Pediatr Surg Int. 2024 Apr 26;40(1):113. doi: 10.1007/s00383-024-05690-4.
The incidence of post-transplant poral vein stenosis (PVS) is higher in pediatric liver transplantation, probably resulting from various portal vein (PV) reconstruction methods or other factors.
332 patients less than 12 years old when receiving liver transplantation (LT) were enrolled in this research. Portal vein reconstruction methods include anastomosis to the left side of the recipient PV trunk (type 1, n = 170), to the recipient left and right PV branch patch (type 2, n = 79), using vein graft interposition (type 3, n = 32), or end-to-end PV anastomosis (type 4, n = 50). The incidence of PVS was analyzed in terms to different PV reconstruction methods and other possible risk factors.
PVS occurred in 35 (10.5%) patients. Of the 32 patients using vein graft, 20 patients received a cryopreserved vein graft, 11 (55%) developed PVS, while the remaining 12 patients received a fresh iliac vein for PV interposition and none of them developed PVS. 9 patients whose liver donor was under 12 years old developed PVS, with an incidence of 18.8%.
Cryopreserved vein graft interposition and a liver donor under 12 are independent risk factors for PVS in pediatric LT.
小儿肝移植后门静脉狭窄（PVS）的发生率较高，可能与各种门静脉（PV）重建方法或其他因素有关。
本研究纳入了 332 名年龄小于 12 岁的肝移植受者。门静脉重建方法包括吻合于受体 PV 干左侧（1 型，n=170）、吻合于受体左、右 PV 分支补片（2 型，n=79）、使用静脉移植物桥接（3 型，n=32）或端端 PV 吻合（4 型，n=50）。分析不同 PV 重建方法和其他可能的危险因素与 PVS 发生率的关系。
35 例（10.5%）患者发生 PVS。32 例使用静脉移植物的患者中，20 例接受冷冻保存的静脉移植物，11 例（55%）发生 PVS，而其余 12 例接受新鲜髂静脉进行 PV 桥接，均未发生 PVS。9 例供肝小于 12 岁的患者发生 PVS，发生率为 18.8%。
冷冻保存静脉移植物桥接和供肝小于 12 岁是小儿肝移植后门静脉狭窄的独立危险因素。
