Vascular thrombosis after pediatric liver transplantation: Is prevention achievable?
dc.contributor.author | Martinez, Mercedes | |
dc.contributor.author | Kang, Elise | |
dc.contributor.author | Beltramo, Fernando | |
dc.contributor.author | Nares, Michael | |
dc.contributor.author | Jeyapalan, Asumthia | |
dc.contributor.author | Alcamo, Alicia | |
dc.contributor.author | Monde, Alexandra | |
dc.contributor.author | Ridall, Leslie | |
dc.contributor.author | Kamath, Sameer | |
dc.contributor.author | Betters, Kristina | |
dc.contributor.author | Rowan, Courtney | |
dc.contributor.author | Mangus, Richard Shane | |
dc.contributor.author | Kaushik, Shubhi | |
dc.contributor.author | Zinter, Matt | |
dc.contributor.author | Resch, Joseph | |
dc.contributor.author | Maue, Danielle | |
dc.contributor.department | Pediatrics, School of Medicine | |
dc.date.accessioned | 2024-04-17T12:16:47Z | |
dc.date.available | 2024-04-17T12:16:47Z | |
dc.date.issued | 2023 | |
dc.description.abstract | Background: Vascular thromboses (VT) are life-threatening events after pediatric liver transplantation (LT). Single-center studies have identified risk factors for intra-abdominal VT, but large-scale pediatric studies are lacking. Methods: This multicenter retrospective cohort study of isolated pediatric LT recipients assessed pre- and perioperative variables to determine VT risk factors and anticoagulation-associated bleeding complications. Results: Within seven postoperative days, 31/331 (9.37%) patients developed intra-abdominal VT. Open fascia occurred more commonly in patients with VT (51.61 vs 23.33%) and remained the only independent risk factor in multivariable analysis (OR = 2.84, p = 0.012). Patients with VT received more blood products (83.87 vs 50.00%), had significantly higher rates of graft loss (22.58 vs 1.33%), infection (50.00 vs 20.60%), and unplanned return to the operating room (70.97 vs 16.44%) compared to those without VT. The risk of bleeding was similar (p = 0.2) between patients on and off anticoagulation. Conclusions: Prophylactic anticoagulation did not increase bleeding complications in this cohort. The only independent factor associated with VT was open fascia, likely a graft/recipient size mismatch surrogate, supporting the need to improve surgical techniques to prevent VT that may not be modifiable with anticoagulation. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | Martinez M, Kang E, Beltramo F, et al. Vascular thrombosis after pediatric liver transplantation: Is prevention achievable?. J Liver Transpl. 2023;12:100185. doi:10.1016/j.liver.2023.100185 | |
dc.identifier.uri | https://hdl.handle.net/1805/40080 | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | |
dc.relation.isversionof | 10.1016/j.liver.2023.100185 | |
dc.relation.journal | Journal of Liver Transplantation | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Pediatric liver transplantation | |
dc.subject | Vascular complications | |
dc.subject | Hepatic artery thrombosis | |
dc.subject | Portal vein thrombosis | |
dc.title | Vascular thrombosis after pediatric liver transplantation: Is prevention achievable? | |
dc.type | Article |