Frequency and Risk Factors of Bowel Perforation in Pediatric Liver Transplant Recipients: A Retrospective Study

Liver transplant is the standard treatment for end-stage liver disease in children, although it carries inherent risks, including complications like bowel perforation. In this retrospective study, we assessed the frequency of bowel perforation in pediatric liver transplant recipients and identified potential risk factors associated with this complication. Our comparison involved pediatric liver transplant recipients who experienced bowel perforation after transplant versus those who did not develop bowel perforation after transplant.

Our retrospective cross-sectional study analyzed 317 children who underwent liver transplant at Shiraz Organ Transplant Center between 2012 and 2020. We reviewed patient records for demographics, surgical history, and perioperative details. We categorized the study population into 2 groups: those with bowel perforation posttransplant and those without bowel perforation posttransplant. We used analyses to identify significant differences between the groups.

Among the 317 patients, 16 (5%) developed bowel perforation. Risk factors, including previous surgery, young age, low weight, and Epstein-Barr virus infection, were associated with bowel perforation. Seven patients with reperforation had a 50% survival rate, and mortality was directly linked to perforation.

Bowel perforation after pediatric liver transplant is influenced by several risk factors, including previous surgery, young age, low weight, and Epstein-Barr virus infection. Early identification of these risk factors is crucial for timely intervention. Further studies are needed to delve into preventive measures and enhance patient outcomes.