Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jul-Sep;20(3):121-6.
doi: 10.4103/0971-9261.154651.

Vascular complications in biliary atresia patients undergoing living donor liver transplantation: Analysis of 110 patients over 10 years

Bhavin Vasavada  1 , Chao Long Chen  2
Affiliations

Vascular complications in biliary atresia patients undergoing living donor liver transplantation: Analysis of 110 patients over 10 years

Bhavin Vasavada et al. J Indian Assoc Pediatr Surg. 2015 Jul-Sep.

Abstract

Introduction: Vascular complications are very common in pediatric living donor liver transplants. We present our experience in vascular complications in biliary atresia patients undergoing liver transplantation.

Materials and methods: All the patients who have undergone living donor liver transplant for biliary atresia from January 2003 to March 2013 were retrospectively analyzed. P value < 0.05 was considered to be statistically significant.

Results: Total 110 patients have undergone living donor liver transplantation for biliary atresia between January 2003 and March 2013. There were 56 males and 54 females. Median age at transplant was 13.5 months. Eleven were primary transplants and 99 were post KASAI procedure. One hundred left lateral, four left lobe, and four right lobe grafts were used. Twenty-two patients developed vascular complications. Twelve patients developed hepatic artery thrombosis. Eleven patients of hepatic artery thrombosis were managed with redo hepatic artery anastomosis and one patient managed with radial artery interposition graft. Five patients developed portal vein stenosis and were managed by portal vein stenting. Five patients developed portal vein thrombosis and portal vein thrombectomy and re-anastomosis were done. One patient developed stenosis at the site of venous anastomosis and was managed by stenting. One patient developed both hepatic artery thrombosis and portal vein thrombosis and eventually succumbed to these complications. Out of five cases who died in this study, two had vascular complications. Graft/recipient weight ratio (GRWR) greater than 2.5 was significantly associated with vascular complications (P = 0.017).

Conclusion: Vascular complications are frequently seen in liver transplantation for biliary atresia. Large for size grafts, weight less than 10 kg, age less than 1 year, and prolonged warm ischemia time is significantly associated with vascular complications.

Keywords: Biliary atresia; hepatic artery thrombosis; live donor liver transplantation; liver transplantation; vascular complications.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Survival was significantly low in hepatic artery thrombosis group
Figure 2
Figure 2
Patients who developed portal vein complications did not differ significantly from patients who did not develop portal vein stenosis
Figure 3
Figure 3
There was no survival difference between patients who developed vascular complications and patients who did not
See this image and copyright information in PMC

References

    1. Khalaf H. Vascular complications after deceased and living donor liver transplantation: A single-center experience. Transplant Proc. 2010;42:865–70. - PubMed
    1. Yilmaz A, Arikan C, Tumgor G, Kilic M, Aydogdu S. Vascular complications in living-related and deceased donation pediatric liver transplantation: Single center atexperience from Turkey. Pediatr Transplant. 2007;11:160–4. - PubMed
    1. Lilly JR, Chandra RS. Surgical hazards of co-existing anomalies in biliary atresia. Surg Gynecol Obstet. 1974;139:49–54. - PubMed
    1. Saad S, Tanaka K, Inomata Y, Uemoto S, Ozaki N, Okajima H, et al. Portal vein reconstruction in pediatric liver transplantation from living donors. Ann Surg. 1998;227:275–81. - PMC - PubMed
    1. de Magnée C, Bourdeaux C, De Dobbeleer F, Janssen M, Menten R, Clapuyt P, et al. Impact of pre-transplant liver hemodynamics and portal reconstruction techniques on post-transplant portal vein complications in pediatric liver transplantation: A retrospective analysis in 197 recipients. Ann Surg. 2011;254:55–61. - PubMed