Dataset Information

Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation.

ABSTRACT:

Objectives

We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients).

Results

In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4-21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaired by BC (p = 0.01). Multivariate analysis identified the number of dilatation courses > 2 (p = 0.008), prolonged cold ischemia time (p = 0.004), anastomosed multiple biliary ducts (p = 0.019) and hepatic artery thrombosis (p = 0.01) as factors associated with impaired graft survival. The number of dilatation courses > 2 (p < 0.001) and intrahepatic vs anastomotic stricture (p = 0.014) were associated with management failure. Thus, repeated (> 2) radiologic dilatation courses are associated with impaired graft survival and management failure. Overall, graft but not patient survival was impaired by BC.

SUBMITTER: Calinescu AM

PROVIDER: S-EPMC10953252 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation.

Calinescu Ana M AM Monluc Sébastien S Franchi-Abella Stephanie S Habes Dalila D Weber Gabrielle G Almes Marion F MF Waguet Jerome J Jacquemin Emmanuel E Fouquet Virginie V Miatello Jordi J Hery Geraldine G Baujard Catherine C Gonzales Emmanuel E Branchereau Sophie S Guérin Florent F

BMC research notes 20240320 1

<h4>Objectives</h4>We aimed to analyze the risk factors for management failure of BC after pediatric liver transplantation (pLT) by retrospectively analyzing primary pLT performed between 1997 and 2018 (n = 620 patients).<h4>Results</h4>In all, 117/620 patients (19%) developed BC. The median (range) follow-up was 9 (1.4-21) years. Patient survival at 1, 5 and 10 years was 88.9%, 85.7%, 84.4% and liver graft survival was 82.4%, 77.4%, and 74.3% respectively. Graft not patient survival was impaire ...[more]

PMID: 38509599

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Project description:PurposePediatric liver transplant surgery is burdened by arterial complications whose endovascular treatment is not standardized. We report the outcomes of a cohort of pediatric recipients with hepatic artery complications treated by endoluminal procedures.Materials and methodsFrom December 2019 to December 2022, consecutive transplanted pediatric patients who underwent endovascular treatment of hepatic artery complications were reviewed. The analysis included: type of complication (occlusion, stenosis, pseudoaneurysm); onset (acute = < 15 days, subacute = 15-90 days, late = > 90 days); endovascular technique (angioplasty, stenting); complications and outcomes. Technical success was defined as the opacification of the hepatic artery at the final angiogram with < 50% residual stenosis and no pseudoaneurysms. Clinical success was defined by graft's and patient's survival.ResultsSeventeen patients (8 males; median age 33 months, IQR 9-103) underwent 21 hepatic arteriography procedures for predominantly acute or subacute occlusions (n = 7) or stenosis (n = 11) with concurrent pseudoaneurysms (n = 4). Primary and secondary technical success was achieved in 13/18 and 3/3 procedures, respectively, with overall technical success of 76%. Angioplasty alone was successful in 5/21 procedures; stent-retriever thrombectomy was performed in one occlusion with thrombosis; stenting was required in 9/17 (53%) patients. Clinical success was obtained in 14/17 (82%) patients with hepatic artery patency after a median of 367 days (IQR 114.5-500). Clinical failure occurred in 3 permanent occlusions, with 2 deaths and 1 re-transplantation. Procedure-related complications included minor events in 3/17 (18%) patients and 1/17 (6%) death.ConclusionIn liver transplanted children with hepatic artery complications, endovascular treatment may provide clinical success, with stenting often required in acute and subacute conditions.Level of evidenceLevel 4.

Project description:BACKGROUND:Orbital cellulitis is an ophthalmic emergency, which is associated with vision-threatening adverse effects. The purpose of this study is investigating etiology, radiologic findings, management and complications of patients with non-medial orbital cellulitis. METHOD:A retrospective medical record and radiologic file review of patients with infectious orbital cellulitis was performed to detect all patients with non-medial orbital cellulitis who referred to Khalili hospital from 2016 to 2019. Age, sex, origin of infection, size of collection or abscess, medical or surgical management, microbiology, first and final best-corrected visual acuity, duration of admission, and complications was recorded. Patients divided into two groups; medical management and surgical management groups and all of data compared between in this groups. RESULTS:Of ninety-six patients with infectious orbital cellulitis, 23 cases (14 male, 9 female) were included. Five patients (21.7%) were managed medically and 18 patients (78.3%) were managed surgically. Patients' age range was 5-70?years old. Most common location for non-medial cellulitis was superior space (66.7% in surgical and 40% in medical group; p?=?0.511). In 13 cases of surgical group (72.3%) were detected microorganisms. The mean?±?SD of collection volume in medical group were 476.5?±?290.93?mm3 and 2572.94?±?1075.75?mm3 in surgical group (p?<?0.001). Ten patients in surgical group had compressive optic neuropathy. The mean?±?SD of collection volume was 3204.97?±?879.88?mm3 in patient with compressive optic neuropathy and 1280.43?±?880.68?mm3 in patient without compressive optic neuropathy (P?<?0.001). One case complicated by subdural empyema and another case progressed to necrotizing fasciitis. CONCLUSION:Non-medial orbital cellulitis is an uncommon but sight-threatening and life-threatening condition. Timely diagnosis and accurate management reduce morbidity and mortality. Combined surgery for patients with superior or supra-temporal and large non-medial abscess is recommended.

Dataset Information

Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation.

Objectives

Results

Publications

Long-term outcome of combined radiologic and surgical strategy for the management of biliary complications after pediatric liver transplantation.

Similar Datasets

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