Perioperative thrombotic complications associated with pediatric liver transplantation

a UNOS database evaluation

Dmitri Bezinover, Molly F. Deacutis, Priti Dalal, Robert P. Moore, Jonathan Stine, Ming Wang, Ethan Reeder, Christopher S. Hollenbeak, Fuat H. Saner, Thomas Riley III, Piotr Janicki

Research output: Contribution to journalArticle

Abstract

Background: This retrospective UNOS database evaluation analyzes the prevalence of preoperative portal vein thromboses (PVT), and postoperative thromboses leading to graft failure in pediatric patients undergoing liver transplantation (LT). Methods: The evaluation was performed in three age groups: I (0–5), II (6–11), III (12–18) years old. Factors predictive of pre- and postoperative thromboses were analyzed. Results: Between 2000 and 2015, 8982 pediatric LT were performed in the US. Of those, 390 patients had preoperative PVT (4.3%), and 396 (4.4%) had postoperative thromboses. The prevalence of both types of thromboses was less in Group III than in the other two groups (3.20% vs 4.65%, p = 0.007 and 1.73% vs. 5.13%, p < 0.001, respectively). The prevalence of postoperative thromboses was significantly higher in Group I than in the other two groups (5.49% vs. 2.51%, p < 0.001). Preoperative PVT was independently associated with postoperative thromboses (OR = 1.7, p = 0.02). Children less than 5 years of age were more likely to develop postoperative thromboses leading to graft failure (OR = 2.9, p < 0.001). Conclusion: Younger children undergoing LT are prone to pre-and postoperative thrombotic complications. Preoperative PVT at the time of transplantation was independently associated with postoperative thromboses. Perioperative antithrombotic therapy should be considered in pediatric patients undergoing LT.

Original languageEnglish (US)
Pages (from-to)370-378
Number of pages9
JournalHPB
Volume21
Issue number3
DOIs
StatePublished - Mar 1 2019

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Liver Transplantation
Thrombosis
Databases
Pediatrics
Portal Vein
Transplants
Age Groups
Transplantation

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{4db9761262c4481499f427bb467561c1,
title = "Perioperative thrombotic complications associated with pediatric liver transplantation: a UNOS database evaluation",
abstract = "Background: This retrospective UNOS database evaluation analyzes the prevalence of preoperative portal vein thromboses (PVT), and postoperative thromboses leading to graft failure in pediatric patients undergoing liver transplantation (LT). Methods: The evaluation was performed in three age groups: I (0–5), II (6–11), III (12–18) years old. Factors predictive of pre- and postoperative thromboses were analyzed. Results: Between 2000 and 2015, 8982 pediatric LT were performed in the US. Of those, 390 patients had preoperative PVT (4.3{\%}), and 396 (4.4{\%}) had postoperative thromboses. The prevalence of both types of thromboses was less in Group III than in the other two groups (3.20{\%} vs 4.65{\%}, p = 0.007 and 1.73{\%} vs. 5.13{\%}, p < 0.001, respectively). The prevalence of postoperative thromboses was significantly higher in Group I than in the other two groups (5.49{\%} vs. 2.51{\%}, p < 0.001). Preoperative PVT was independently associated with postoperative thromboses (OR = 1.7, p = 0.02). Children less than 5 years of age were more likely to develop postoperative thromboses leading to graft failure (OR = 2.9, p < 0.001). Conclusion: Younger children undergoing LT are prone to pre-and postoperative thrombotic complications. Preoperative PVT at the time of transplantation was independently associated with postoperative thromboses. Perioperative antithrombotic therapy should be considered in pediatric patients undergoing LT.",
author = "Dmitri Bezinover and Deacutis, {Molly F.} and Priti Dalal and Moore, {Robert P.} and Jonathan Stine and Ming Wang and Ethan Reeder and Hollenbeak, {Christopher S.} and Saner, {Fuat H.} and {Riley III}, Thomas and Piotr Janicki",
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day = "1",
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Perioperative thrombotic complications associated with pediatric liver transplantation : a UNOS database evaluation. / Bezinover, Dmitri; Deacutis, Molly F.; Dalal, Priti; Moore, Robert P.; Stine, Jonathan; Wang, Ming; Reeder, Ethan; Hollenbeak, Christopher S.; Saner, Fuat H.; Riley III, Thomas; Janicki, Piotr.

In: HPB, Vol. 21, No. 3, 01.03.2019, p. 370-378.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Perioperative thrombotic complications associated with pediatric liver transplantation

T2 - a UNOS database evaluation

AU - Bezinover, Dmitri

AU - Deacutis, Molly F.

AU - Dalal, Priti

AU - Moore, Robert P.

AU - Stine, Jonathan

AU - Wang, Ming

AU - Reeder, Ethan

AU - Hollenbeak, Christopher S.

AU - Saner, Fuat H.

AU - Riley III, Thomas

AU - Janicki, Piotr

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: This retrospective UNOS database evaluation analyzes the prevalence of preoperative portal vein thromboses (PVT), and postoperative thromboses leading to graft failure in pediatric patients undergoing liver transplantation (LT). Methods: The evaluation was performed in three age groups: I (0–5), II (6–11), III (12–18) years old. Factors predictive of pre- and postoperative thromboses were analyzed. Results: Between 2000 and 2015, 8982 pediatric LT were performed in the US. Of those, 390 patients had preoperative PVT (4.3%), and 396 (4.4%) had postoperative thromboses. The prevalence of both types of thromboses was less in Group III than in the other two groups (3.20% vs 4.65%, p = 0.007 and 1.73% vs. 5.13%, p < 0.001, respectively). The prevalence of postoperative thromboses was significantly higher in Group I than in the other two groups (5.49% vs. 2.51%, p < 0.001). Preoperative PVT was independently associated with postoperative thromboses (OR = 1.7, p = 0.02). Children less than 5 years of age were more likely to develop postoperative thromboses leading to graft failure (OR = 2.9, p < 0.001). Conclusion: Younger children undergoing LT are prone to pre-and postoperative thrombotic complications. Preoperative PVT at the time of transplantation was independently associated with postoperative thromboses. Perioperative antithrombotic therapy should be considered in pediatric patients undergoing LT.

AB - Background: This retrospective UNOS database evaluation analyzes the prevalence of preoperative portal vein thromboses (PVT), and postoperative thromboses leading to graft failure in pediatric patients undergoing liver transplantation (LT). Methods: The evaluation was performed in three age groups: I (0–5), II (6–11), III (12–18) years old. Factors predictive of pre- and postoperative thromboses were analyzed. Results: Between 2000 and 2015, 8982 pediatric LT were performed in the US. Of those, 390 patients had preoperative PVT (4.3%), and 396 (4.4%) had postoperative thromboses. The prevalence of both types of thromboses was less in Group III than in the other two groups (3.20% vs 4.65%, p = 0.007 and 1.73% vs. 5.13%, p < 0.001, respectively). The prevalence of postoperative thromboses was significantly higher in Group I than in the other two groups (5.49% vs. 2.51%, p < 0.001). Preoperative PVT was independently associated with postoperative thromboses (OR = 1.7, p = 0.02). Children less than 5 years of age were more likely to develop postoperative thromboses leading to graft failure (OR = 2.9, p < 0.001). Conclusion: Younger children undergoing LT are prone to pre-and postoperative thrombotic complications. Preoperative PVT at the time of transplantation was independently associated with postoperative thromboses. Perioperative antithrombotic therapy should be considered in pediatric patients undergoing LT.

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U2 - 10.1016/j.hpb.2018.08.014

DO - 10.1016/j.hpb.2018.08.014

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