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Gastrointestinal perforations and associated risk factors in children after liver transplantation

Serdar Aslan1, Zeliha Akış Yıldız2, Şerafettin Yazar1

  • 1Liver Transplant Center, Memorial Ataşehir/Bahçelievler Hospitals, İstanbul, Turkey.

Pediatric Transplantation
|November 5, 2020
PubMed

Insights

Gastrointestinal perforations (GIP) in pediatric liver transplant recipients are linked to younger age, lower weight, and more surgeries. Biliary atresia patients face a higher GIP risk, necessitating close monitoring and early intervention to reduce mortality.

Area of Science:

  • Pediatric Surgery
  • Hepatology
  • Transplantation Medicine

Background:

  • Gastrointestinal perforations (GIP) are a serious complication following pediatric liver transplantation.
  • Identifying risk factors is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To investigate risk factors associated with gastrointestinal perforations (GIP) in children undergoing liver transplantation.
  • To analyze the impact of GIP on mortality and morbidity.
  • To compare outcomes in patients with biliary atresia versus other etiologies.

Main Methods:

  • Retrospective analysis of 131 pediatric patients undergoing 139 liver transplants (January 2016 - February 2020).
  • Evaluation of preoperative and surgical data.
  • Comparison of cases with biliary atresia to other etiological groups.

Main Results:

  • Patients developing GIP were younger, had lower weight, and underwent more surgeries.
  • GIP cases exhibited higher mortality and morbidity rates.
  • Biliary atresia patients were transplanted at a younger age and lower weight, presenting a higher perforation risk.

Conclusions:

  • Younger age, lower weight, and prior surgeries are significant risk factors for GIP post-pediatric liver transplant.
  • Biliary atresia is an independent risk factor for GIP in this cohort.
  • Early laparotomy and close monitoring of high-risk patients are recommended to decrease mortality.

Keywords:
GIPmortalityoutcomepediatric liver transplantationrisk factor

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