Bowel perforation after liver transplantation for biliary atresia: a retrospective study of care in the transition from children to adulthood

Yusuke Yanagi, Toshiharu Matsuura, Makoto Hayashida, Yoshiaki Takahashi, Koichiro Yoshimaru, Genshirou Esumi, Tomoaki Taguchi

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Abstract

Purpose: We evaluated the outcomes of liver transplantation (LT) in pediatric and adult patients with biliary atresia (BA). We focused on bowel perforation after LT (BPLT) as the most common surgical complication and analyzed its risk factors. Methods: This was a retrospective analysis of 70 BA patients who underwent LT. The patients were divided into three groups according to the timing of LT: within the first year of age (Group A), between 1 and 12 years of age (Group B), and after 12 years of age (Group C). The outcomes of LT and the clinical presentations of BPLT were compared. The surgical variables of patients with and without BPLT were analyzed to assess the risk factors. Results: The timing of LT did not affect patient survival. The incidence of BPLT was significantly higher in Group C. In Group C, BPLT progressed to severe peritonitis. No cases of BPLT-associated mortality were observed. A multivariate analysis revealed that a prolonged operative time for LT was an independent risk factor (p = 0.03). Conclusion: The clinical course after transplantation was complicated after adolescence. BPLT should be strongly suspected and relaparotomy should be performed in a timely manner for patients undergoing LT after adolescence.

Original languageEnglish
Pages (from-to)155-163
Number of pages9
JournalPediatric surgery international
Volume33
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

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Biliary Atresia
Patient Transfer
Liver Transplantation
Retrospective Studies
Age Groups
Operative Time
Peritonitis
Multivariate Analysis
Transplantation
Pediatrics
Survival
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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Bowel perforation after liver transplantation for biliary atresia : a retrospective study of care in the transition from children to adulthood. / Yanagi, Yusuke; Matsuura, Toshiharu; Hayashida, Makoto; Takahashi, Yoshiaki; Yoshimaru, Koichiro; Esumi, Genshirou; Taguchi, Tomoaki.

In: Pediatric surgery international, Vol. 33, No. 2, 01.02.2017, p. 155-163.

Research output: Contribution to journalArticle

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