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Aggressive prevention and preemptive management of vascular complications after pediatric liver transplantation: A major impact on graft survival and long‐term outcome
Author(s) -
Grimaldi Chiara,
di Francesco Fabrizio,
Chiusolo Fabrizio,
Angelico Roberta,
Monti Lidia,
Muiesan Paolo,
Ville de Goyet Jean
Publication year - 2018
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/petr.13288
Subject(s) - medicine , liver transplantation , surgery , revascularization , incidence (geometry) , perioperative , transplantation , myocardial infarction , physics , optics
Vascular complications are a major cause of patient and graft loss after LT s. The aim of this study was to evaluate the effect of a multimodal perioperative strategy aimed at reducing the incidence of vascular complications. A total of 126 first isolated LT s—performed between November 2008 and December 2015—were retrospectively analyzed. A minimum follow‐up period of 24 months was analyzable for 124/126 patients (98.4%). The aggressive preemptive strategy consisted of identifying and immediately managing any problem and any abnormality in the vascular flow, in any of the hepatic vessels, and at any time after the liver graft revascularization. As a result, with a median follow‐up of 57 months (3‐112 months), not a single graft has been lost from vascular or biliary problems. The actuarial 8‐year graft survival is 96.5%. These results have shown that a combination of technical attention, medical prevention, an early diagnosis, and rapid interventions reduced the negative impact of vascular problems on the outcome of both grafts and patients.