TY - JOUR
T1 - Perioperative thrombotic complications associated with pediatric liver transplantation
T2 - a UNOS database evaluation
AU - Bezinover, Dmitri
AU - Deacutis, Molly F.
AU - Dalal, Priti G.
AU - Moore, Robert P.
AU - Stine, Jonathan G.
AU - Wang, Ming
AU - Reeder, Ethan
AU - Hollenbeak, Christopher S.
AU - Saner, Fuat H.
AU - Riley, Thomas R.
AU - Janicki, Piotr K.
N1 - Funding Information:
The authors would like to thank Dr. Patrick M. McQuillan, Professor of Anesthesiology and Pediatrics at The Penn State Hershey Medical Center, for his help with editing and rewriting this article.
Publisher Copyright:
© 2018 International Hepato-Pancreato-Biliary Association Inc.
PY - 2019/3
Y1 - 2019/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85053883924&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2018.08.014
DO - 10.1016/j.hpb.2018.08.014
M3 - Article
C2 - 30266497
AN - SCOPUS:85053883924
SN - 1365-182X
VL - 21
SP - 370
EP - 378
JO - HPB
JF - HPB
IS - 3
ER -