Post liver transplantation complications in pediatric patients in a third level hospital, Lima-Peru, 2016-2020

Authors

DOI:

https://doi.org/10.47892/rgp.2024.442.1606

Keywords:

Liver transplantation, Pediatrics, Peru

Abstract

Objective: determine the complications during the first year after liver transplantation in pediatric patients of the INSN-SB during the period 2016-2020. Materials and methods: Descriptive, cross-sectional study. The medical records of liver transplant patients seen during post-transplant follow-up at the INSN-SB were reviewed, collecting epidemiological characteristics, transplant indication; PELD score, CHILD score and complications prior to the transplant, as well as the frequency of the main complications presented during the first year after the transplant. Results: Of the 16 patients evaluated, 62.5% were under 1 year of age, with a median weight of 7.4kg, 50% presented a CHILD C score, with a median PELD of 23, the main reason for transplantation was atresia of bile ducts (62.5%), the main complications prior to transplantation were portal hypertension (75%) and malnutrition (68.8%). All posttransplant patients presented at least one infectious complication: bacterial (53%), CMV infection (75%) and EBV infection (31%); Regarding vascular complications, 25% presented portal vein thrombosis and one patient (6%) presented hepatic artery stenosis; Regarding biliary complications, 12.5% presented biliary fistula, also 12.5% presented bile duct dilation, while 6.25% presented bilioma. Conclusions: Among the main complications of the postliver transplant patient, we can highlight that all patients presented at least one infectious complication (100%), vascular complications in 31% and biliary complications in 31.25% of patients.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Spada M, Riva S, Maggiore G, Cintorino D, Gridelli B. Pediatric liver transplantation. World J Gastroenterol. 2009;15(6):648-74. doi: 10.3748/wjg.15.648.

Kelly DA, Bucuvalas JC, Alonso EM, Karpen SJ, Allen U, Green M, et al. Long-term medical management of the pediatric patient after liver transplantation: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Liver Transpl. 2013 Aug;19(8):798-825. doi: 10.1002/lt.23697.

De la Mata M, Rodríguez Perálvarez ML. Complicaciones en el periodo precoz postrasplante hepático. En: Gastroenterología y Hepatología: Problemas Comunes En La Práctica Clínica. 2a ed. Madrid, España: Jarpyo Editores, S.A; 2012.

Karjoo M, Kiani M, Sarveazad A, Saeidi M. Short and long term complications after pediatric liver transplantation: a review and literature. Int J Pediatr. 2017;5(48):12. doi: 10.22038/ijp.2017.26816.2312.

Council for International Organizations of Medical Sciences. International ethical guidelines for health-related research involving humans [Internet]. 4th ed. Geneva: CIOMS; 2017 [citado 18 de septiembre de 2019]. Disponible en: https://cioms.ch/wpcontent/uploads/2017/01/WEB-CIOMS-EthicalGuidelines.pdf

Lilly JR, Chandra RS. Surgical hazards of co-existing anomalies in biliary atresia. Surg Gynecol Obstet. 1974;139(1):49-54.

Khalaf H. Vascular complications after deceased and living donor liver transplantation: a single-center experience. Transplant Proc. 2010;42(3):865-70. doi: 10.1016/j.transproceed.2010.02.037.

Vasavada B, Chen CL. Vascular complications in biliary atresia patients undergoing living donor liver transplantation: Analysis of 110 patients over 10 years. J Indian Assoc Pediatr Surg. 2015;20(3):121-6. doi: 10.4103/0971-9261.154651.

Orlandini M, Feier FH, Jaeger B, Kieling C, Vieira SG, Zanotelli ML. Frequency of and factors associated with vascular complications after pediatric liver transplantation. J Pediatr (Rio J). 2014;90(2):169-75. doi: 10.1016/j.jped.2013.08.010.

Khan AS, Brauer DG, Dageforde L, Nadler M, Turmelle Y, Stohl J, et al. Biliary complications after pediatric liver transplantation. HPB. 2018;20(1):S78-S79. doi: 10.1016/j.hpb.2018.02.312.

Laurence JM, Sapisochin G, DeAngelis M, Seal JB, Miserachs MM, Marquez M, et al. Biliary complications in pediatric liver transplantation: Incidence and management over a decade. Liver Transpl. 2015;21(8):1082-90. doi: 10.1002/lt.24180.

Hsiao CY, Ho CM, Wu YM, Ho MC, Hu RH, Lee PH. Biliary Complication in Pediatric Liver Transplantation: a Single-Center 15-Year Experience. J Gastrointest Surg. 2019;23(4):751-759. doi: 10.1007/s11605-018-04076-x.

Kim SI. Bacterial infection after liver transplantation. World J Gastroenterol. 2014 May 28;20(20):6211-20. doi: 10.3748/wjg.v20.i20.6211.

Saint-Vil D, Luks FI, Lebel P, Brandt ML, Paradis K, Weber A, et al. Infectious complications of pediatric liver transplantation. J Pediatr Surg. 1991;26(8):908-13. doi: 10.1016/0022-3468(91)90835-h

Behairy BE, Konsowa HA, Zakaria HM, Elsalam OH, Sira MM. Infection after Pediatric Living Related Liver Transplantation: Timing, Types and Risk Factors. Int J Transplant Res Med [Internet]. 2015 [citado 18 de septiembre de 2019];1(3). Disponible en: https://clinmedjournals.org/articles/ijtrm/international-journal-of-transplantation-research-and-medicine-ijtrm-1-012.php?jid=ijtrm

Cuenca AG, Kim HB, Vakili K. Pediatric liver transplantation. Semin Pediatr Surg. 2017;26(4):217-223. doi: 10.1053/j.sempedsurg.2017.07.014.

Öztürk H, Ekşi Bozbulut N, Sarı S, Eğritaş Gürkan Ö, Sözen H, Sapmaz A, et al. Predictable and Unusual Adverse Effects of Immunosuppression in Pediatric Liver Transplant Patients. Exp Clin Transplant. 2019;17(Suppl 1):230-233. doi: 10.6002/ect.MESOT2018.P81.

Miloh T, Barton A, Wheeler J, Pham Y, Hewitt W, Keegan T, Sanchez C, Bulut P, Goss J. Immunosuppression in pediatric liver transplant recipients: Unique aspects. Liver Transpl. 2017;23(2):244-256. doi: 10.1002/lt.24677.

Published

06/26/2024

How to Cite

1.
Castro-Johanson R, Tello Quispe G, Verastegui S. R, Perez Rodriguez D. Post liver transplantation complications in pediatric patients in a third level hospital, Lima-Peru, 2016-2020. Rev Gastroenterol Peru [nternet]. 2024 Jun. 26 [cited 2024 Nov. 24];44(2). vailable from: https://revistagastroperu.com/index.php/rgp/article/view/1606

Issue

Section

ARTÍCULOS ORIGINALES

Most read articles by the same author(s)