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Long‐term follow‐up of portal hypertension after liver transplantation in children
Author(s) -
Ling S. C.,
Pfeiffer A.,
Avitzur Y.,
Fecteau A.,
Grant D.,
Ng V. L.
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.00993.x
Subject(s) - medicine , portal hypertension , ascites , liver transplantation , transplantation , surgery , retrospective cohort study , liver disease , cirrhosis
We aimed to describe the long‐term changes in the imaging and clinical features of PHALT in children. A retrospective review was undertaken of consecutive children undergoing their first liver transplant between 1993 and 2003. Details of clinical progress and ultrasound imaging were recorded at one‐yr post‐transplantation and at last follow‐up. Data were extracted on 83 children (median age at transplant 1.7 yr, range one month to 17.5 yr, 44 girls) who underwent 89 transplants. Four of these children died at a mean 5.6 yr (range 3.8–6.9 yr) after transplantation. Of the survivors, follow‐up at one yr (n = 83) and at last follow‐up (n = 71, median 4.3 yr post‐transplant) revealed imaging evidence of splenomegaly in 46% and 44%, ascites in 6% and 4%, and portal systemic collaterals in 12% and 14%, respectively. Gastrointestinal hemorrhage associated with portal hypertension had occurred in no children at one yr and in four (6%) at latest follow‐up. Features of portal hypertension on ultrasound scan are common in children before liver transplantation. An important minority of children will suffer clinically significant complications of PHALT during long‐term follow‐up, caused by both vascular and parenchymal disease.