Biliary complications after pediatric liver transplantation: Risk factors, diagnosis and management

World Journal of Hepatology
Flávia H FeierPaulo Chapchap

Abstract

The expanded indications of partial grafts in pediatric liver transplantation have reduced waiting list mortality. However, a higher morbidity is observed, including an increased rate of biliary complications (BCs). Factors such as the type of graft, the preservation methods applied, the donor characteristics, the type of biliary reconstruction, and the number of bile ducts in the liver graft influences the occurrence of these complications. Bile leaks and strictures comprise the majority of post-transplant BCs. Biliary strictures require a high grade of suspicion, and because most children have a bileo-enteric anastomosis, its diagnosis and management rely on percutaneous hepatic cholangiography and percutaneous biliary interventions (PBI). The success rates with PBI range from 70% to 90%. Surgery is reserved for patients who have failed PBI. BCs in children after liver transplantation have a prolonged treatment and are associated with a longer length of stay and higher hospital costs. However, with early diagnosis and aggressive treatment, patient and graft survival are not significantly compromised.

References

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Citations

Jun 28, 2016·Pediatric Transplantation·Victoria ShakhinRonen Arnon
Jan 12, 2017·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Fernando Pompeu Piza VicentineAlcides Augusto Salzedas-Netto
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Feb 6, 2018·World Journal of Hepatology·Rashid AlobaidiAri R Joffe
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Dec 31, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Claudia Gutierrez-VillamilVíctor Marín-Oyaga

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