Increased risk of vascular thrombosis in pediatric liver transplant recipients with thrombophilia

David J. Cha, Edward J. Alfrey, Dev M. Desai, Malcolm Macconmara, Christine S. Hwang

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4 Citations (Scopus)

Abstract

Background: Pediatric patients who undergo liver transplantation are at higher risk of developing vascular complications when compared to adult liver transplant recipients. The consequences of hepatic artery thrombosis (HAT) or portal vein thrombosis (PVT) can cause significant morbidity and mortality. We examined pediatric liver transplant recipients who developed vascular thrombosis and the presence of thrombophilia. Methods: We examined outcome in all pediatric patients who underwent liver transplantation. Recipient, donor demographic data, and outcome data were examined. Categorical differences were compared using the unpaired Student t-test and nominal variables using either the chi-square or the Fischer exact test. A P value of <0.05 was considered significant. Results: Forty-six pediatric patients underwent liver transplantation. Twenty-one recipients were found to have thrombophilia, including 5 with HAT and 2 with PVT. When comparing recipients with or without any vascular thrombosis, those with thrombophilia had a significantly higher incidence of developing a vascular thrombosis (7/21 versus 0/25, P=0.0017). Five of 42 recipients with artery-to-artery reconstruction developed HAT versus 0 of 4 with a conduit. Recipients who developed any thrombosis were significantly lower in weight than those who did not develop any thrombosis (9.0±1.6kg versus 22.2±16.0kg, P=0.0366). Conclusions: All pediatric liver transplant recipients who developed any vascular thrombosis were also found to have thrombophilia. Recipients who were smaller in size were at significantly higher risk of developing vascular thrombosis. Lower weight recipients with thrombophilia may benefit from arterial reconstruction with a conduit to decrease the risk of vascular thrombosis.

Original languageEnglish (US)
JournalJournal of Surgical Research
DOIs
StateAccepted/In press - Jan 3 2015

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Thrombophilia
Blood Vessels
Thrombosis
Pediatrics
Liver
Hepatic Artery
Liver Transplantation
Portal Vein
Transplant Recipients
Arteries
Weights and Measures

Keywords

  • Liver transplant
  • Pediatric
  • Rejection
  • Thrombophilia
  • Thrombosis

ASJC Scopus subject areas

  • Surgery

Cite this

@article{7e83e2e020e64a11a5de9a6e5c2aefff,
title = "Increased risk of vascular thrombosis in pediatric liver transplant recipients with thrombophilia",
abstract = "Background: Pediatric patients who undergo liver transplantation are at higher risk of developing vascular complications when compared to adult liver transplant recipients. The consequences of hepatic artery thrombosis (HAT) or portal vein thrombosis (PVT) can cause significant morbidity and mortality. We examined pediatric liver transplant recipients who developed vascular thrombosis and the presence of thrombophilia. Methods: We examined outcome in all pediatric patients who underwent liver transplantation. Recipient, donor demographic data, and outcome data were examined. Categorical differences were compared using the unpaired Student t-test and nominal variables using either the chi-square or the Fischer exact test. A P value of <0.05 was considered significant. Results: Forty-six pediatric patients underwent liver transplantation. Twenty-one recipients were found to have thrombophilia, including 5 with HAT and 2 with PVT. When comparing recipients with or without any vascular thrombosis, those with thrombophilia had a significantly higher incidence of developing a vascular thrombosis (7/21 versus 0/25, P=0.0017). Five of 42 recipients with artery-to-artery reconstruction developed HAT versus 0 of 4 with a conduit. Recipients who developed any thrombosis were significantly lower in weight than those who did not develop any thrombosis (9.0±1.6kg versus 22.2±16.0kg, P=0.0366). Conclusions: All pediatric liver transplant recipients who developed any vascular thrombosis were also found to have thrombophilia. Recipients who were smaller in size were at significantly higher risk of developing vascular thrombosis. Lower weight recipients with thrombophilia may benefit from arterial reconstruction with a conduit to decrease the risk of vascular thrombosis.",
keywords = "Liver transplant, Pediatric, Rejection, Thrombophilia, Thrombosis",
author = "Cha, {David J.} and Alfrey, {Edward J.} and Desai, {Dev M.} and Malcolm Macconmara and Hwang, {Christine S.}",
year = "2015",
month = "1",
day = "3",
doi = "10.1016/j.jss.2015.07.043",
language = "English (US)",
journal = "Journal of Surgical Research",
issn = "0022-4804",
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TY - JOUR

T1 - Increased risk of vascular thrombosis in pediatric liver transplant recipients with thrombophilia

AU - Cha, David J.

AU - Alfrey, Edward J.

AU - Desai, Dev M.

AU - Macconmara, Malcolm

AU - Hwang, Christine S.

PY - 2015/1/3

Y1 - 2015/1/3

N2 - Background: Pediatric patients who undergo liver transplantation are at higher risk of developing vascular complications when compared to adult liver transplant recipients. The consequences of hepatic artery thrombosis (HAT) or portal vein thrombosis (PVT) can cause significant morbidity and mortality. We examined pediatric liver transplant recipients who developed vascular thrombosis and the presence of thrombophilia. Methods: We examined outcome in all pediatric patients who underwent liver transplantation. Recipient, donor demographic data, and outcome data were examined. Categorical differences were compared using the unpaired Student t-test and nominal variables using either the chi-square or the Fischer exact test. A P value of <0.05 was considered significant. Results: Forty-six pediatric patients underwent liver transplantation. Twenty-one recipients were found to have thrombophilia, including 5 with HAT and 2 with PVT. When comparing recipients with or without any vascular thrombosis, those with thrombophilia had a significantly higher incidence of developing a vascular thrombosis (7/21 versus 0/25, P=0.0017). Five of 42 recipients with artery-to-artery reconstruction developed HAT versus 0 of 4 with a conduit. Recipients who developed any thrombosis were significantly lower in weight than those who did not develop any thrombosis (9.0±1.6kg versus 22.2±16.0kg, P=0.0366). Conclusions: All pediatric liver transplant recipients who developed any vascular thrombosis were also found to have thrombophilia. Recipients who were smaller in size were at significantly higher risk of developing vascular thrombosis. Lower weight recipients with thrombophilia may benefit from arterial reconstruction with a conduit to decrease the risk of vascular thrombosis.

AB - Background: Pediatric patients who undergo liver transplantation are at higher risk of developing vascular complications when compared to adult liver transplant recipients. The consequences of hepatic artery thrombosis (HAT) or portal vein thrombosis (PVT) can cause significant morbidity and mortality. We examined pediatric liver transplant recipients who developed vascular thrombosis and the presence of thrombophilia. Methods: We examined outcome in all pediatric patients who underwent liver transplantation. Recipient, donor demographic data, and outcome data were examined. Categorical differences were compared using the unpaired Student t-test and nominal variables using either the chi-square or the Fischer exact test. A P value of <0.05 was considered significant. Results: Forty-six pediatric patients underwent liver transplantation. Twenty-one recipients were found to have thrombophilia, including 5 with HAT and 2 with PVT. When comparing recipients with or without any vascular thrombosis, those with thrombophilia had a significantly higher incidence of developing a vascular thrombosis (7/21 versus 0/25, P=0.0017). Five of 42 recipients with artery-to-artery reconstruction developed HAT versus 0 of 4 with a conduit. Recipients who developed any thrombosis were significantly lower in weight than those who did not develop any thrombosis (9.0±1.6kg versus 22.2±16.0kg, P=0.0366). Conclusions: All pediatric liver transplant recipients who developed any vascular thrombosis were also found to have thrombophilia. Recipients who were smaller in size were at significantly higher risk of developing vascular thrombosis. Lower weight recipients with thrombophilia may benefit from arterial reconstruction with a conduit to decrease the risk of vascular thrombosis.

KW - Liver transplant

KW - Pediatric

KW - Rejection

KW - Thrombophilia

KW - Thrombosis

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DO - 10.1016/j.jss.2015.07.043

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JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

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