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Frequency and Risk Factors of Bowel Perforation in Pediatric Liver Transplant Recipients: A Retrospective Study
Seyyed Mohsen Dehghani1, Seyyedeh Rabie Seifi, Masoud Tahani
1From the Shiraz Transplant Research Center, Shiraz University of Medical Science, Shiraz, Iran.
Insights
Bowel perforation occurs in 5% of pediatric liver transplant recipients. Risk factors include prior surgery, young age, low weight, and Epstein-Barr virus infection, impacting survival rates.
Area of Science:
- Pediatric Surgery
- Hepatology
- Transplantation Medicine
Background:
- Liver transplantation is a critical treatment for pediatric end-stage liver disease.
- Complications such as bowel perforation pose significant risks to transplant recipients.
- Identifying risk factors is essential for improving outcomes in pediatric liver transplant patients.
Purpose of the Study:
- To determine the incidence of bowel perforation in children undergoing liver transplant.
- To identify risk factors associated with post-transplant bowel perforation in pediatric recipients.
- To compare outcomes between pediatric liver transplant patients with and without bowel perforation.
Main Methods:
- A retrospective cross-sectional study was conducted.
- Data from 317 pediatric liver transplant recipients (2012-2020) were analyzed.
- Patients were categorized into groups with and without post-transplant bowel perforation.
Main Results:
- Bowel perforation occurred in 16 (5%) of the 317 pediatric liver transplant patients.
- Identified risk factors included previous surgery, young age, low weight, and Epstein-Barr virus infection.
- Mortality was directly linked to perforation, with a 50% survival rate in patients experiencing reperforation.
Conclusions:
- Bowel perforation following pediatric liver transplant is associated with specific risk factors.
- Early recognition of risk factors like prior surgery, young age, low weight, and EBV infection is vital.
- Further research into preventive strategies is necessary to improve patient outcomes.
Objectives:
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.
Materials And Methods:
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.
Results:
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.
Conclusions:
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.
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