{
  "abstract": "The long-term outcome of pediatric liver transplantation (LTx) is determined by complications(vascular, hematological and infectious etc) that occur both immediately post-transplantation and in the long-term. 1 We aimed to analyze the pattern and risk factors for vascular complications (VC) in a single tertiary LTx center. A retrospective analysis on children undergoing LTx over 10 yrs (2013- 2023). Liver unit database, medical records were reviewed in different time periods post-transplant (week, 3 m , 6 m , 1 year, 5 yr, 10 yr, 15 yr for vascular complications e.g hepatic artery thrombosis (HAT) and stenosis (HAS) , portal vein thrombosis (PVT) and stenosis (PVS) and Hepatic vein thrombosis (HVT).Abstract OC11 Table 1Demographic and vascular complications: n=300Age median (IQR in years) 7.00 (3.00–11.00) Weight median (IQR in kg) 15.00 (8.80–29.00) Diagnosis Biliary Atresia 103 (34.3%) Acute liver failure 38 (12.7%) Autoimmune liver disease 19 (6.3%) Metabolic liver disease 69 (23%) Hepatoblastoma 40 (13.3%) Others 31 (10.3%) Height median (IQR in cm) 92.20 (73.50–130.70) Early Hepatic Artery Thrombosis with in the first month 12 (4.0%) Late Hepatic Artery Thrombosis after the first month 8 (2.7%) Hepatic artery stenosis 6 (2.0%) Portal vein thrombosis 17 (5.6%) Portal vein stenosis 15 (5.0%) Hepatic vein thrombosis 3 (1.0%) In early HAT : 2/12 underwent re-transplantation and 10/12 children underwent surgical treatment (thrombectomy n=6 , re-anastomosis n=3 , thrombectomy and re-anastomosis n=1). 7/20 with HAT died due to multi organ failure, bleeding or biliary sepsis (median time to death 9 days ,range from 1 -790 days) Multivariate analysis found significant correlation between incidence of HAT with split graft, cold ischemia time, recipient weight less than 10 kg.HAS 6 patients post-transplant: 2/6 had balloon angioplasty,3/6 of them had stenosis of only one segment of HA, with patient main HA, normal LFTS and were maintained on anticoagulation, 1 died due to MOF and sepsisPVT occurred in 17 patients (median 4 days, range 1–1155 days) 9/17 had early PVT (n=5 re-exploration and patency, 3 non-occlusive thrombus- conservative management, 1 had Interventional radiology). All of them survived immediate intervention and in late PVT 8/17- 3 died median time to death is 545 days (range 90 – 1245 days). Multivariate analysis found a significant correlation between recipient weight less than 10 kg, donor-recipient size mismatch, split liver graft and pre-existing portal vein condition.Biliary atresia was a common diagnosis in children with HAT 6/20 (30%) and PVT 9/17 (45%) . The other common condition in HAT was metabolic liver disease.3 patients developed HVT (median range) and had stents inserted by hepatic venography and were maintained on long term anticoagulation.Recipients with less than 10 kg, split graft recipients and longer cold ischemic times had a higher incidence of vascular complications. A high index of suspicion needs to be maintained in the evaluation of the children with biliary atresia and metabolic liver disease patients peri-operatively and in long term follow-up.Reference Bucuvalas J. Long-term outcomes in pediatric liver transplantation. Liver Transpl. 2009;15Suppl 2:S6–11.",
  "authors": [
    {
      "affiliations": [
        "Assiut University Children Hospital"
      ],
      "name": "Ahmed Elhomosany"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Khalid Sharif"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Alba Bueno Jimenez"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Chaya Kelgeri"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Jane Hartely"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Rebeca Sanabria Mateos"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Hector Vilca-Melendez"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Darius Mirza"
    },
    {
      "affiliations": [
        "Birmingham Women’s and Children’s NHS Foundation Trust"
      ],
      "name": "Girish Gupte"
    }
  ],
  "title": "OC11 Vascular complications following liver transplantation- a single centre experience over 10 years",
  "uid": "b250660d-68ed-5e85-b4f9-53cfe969f1ae"
}