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Case series and systematic review of acquired diaphragmatic hernia after liver transplantation
Author(s) -
Emamaullee Juliet A.,
Nekrasov Victor,
Gilmour Susan,
Kneteman Norman,
Yanni George,
Kohli Rohit,
Thomas Daniel,
Genyk Yuri
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.13296
Subject(s) - medicine , complication , incidence (geometry) , immunosuppression , liver transplantation , demographics , pediatrics , transplantation , surgery , physics , demography , sociology , optics
Background ADH is a rare and potentially fatal complication following LT . In this study, a systematic review was completed to identify risk factors which may contribute to ADH . Methods Transplant databases at three LT programs were reviewed. Four pediatric and zero adult cases were identified. Next, a systematic review was completed. Fourteen studies describing 41 patients with ADH were identified. Patient demographics, transplant characteristics, and features of ADH diagnosis were examined. Results The majority (90.2%) of ADH were in children . In pediatric LT , 95.1% received a segmental allograft. ADH occurred in the right P diaphragm 92.7% of the time, and 87.8% were repaired primarily. Patient demographics, post‐transplant complications, and immunosuppression regimens were broad and failed to predict ADH . Most patients presented with either respiratory or gastrointestinal symptoms. There were two pediatric deaths related to undiagnosed ADH . The combined worldwide incidence of ADH in pediatric LT is 1.5% (34/2319 patients). Conclusion ADH is a rare complication post‐ LT that primarily occurs in pediatric recipients. When diagnosed early, ADH can be repaired primarily with good outcomes.