Медицинская библиотека · Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025

Management of hepatic artery thrombosis and stenosis after pediatric liver transplantation: Variability and agreement in management practices.

Li Weihao, Bokkers Reinoud P H, Wildhaber Barbara E, Calinescu Ana M, Ricoeur Alexis, Marra Paolo, Bravi Michela, Pinelli Domenico, Minetto Julia, Dip Marcelo, Sierre Sergio, de Santibañes Martín, Ardiles Victoria, Uno Jimmy Walker, Hardikar Winita, Bates Sue, Goh Lynette, Aldrian Denise, Seisenbacher Jonathan, Vogel Georg F, Neto João Seda, da Fonseca Eduardo Antunes, Costa Carolina Magalhães, Ferreira Cristina T, Nader Luiza S, Farina Marco A, Dajani Khaled Z, Parente Alessandro, Bigam David L, Liang Tingbo, Bai Xueli, Xiang Jie, Gonsorčíková Lucie, Froněk Jiří, Bohuš Šimon, Franchi-Abella Stéphanie, Gonzales Emmanuel, Guérin Florent, Junge Norman, Baumann Ulrich, Richter Nicolas, Hartleif Steffen, Sturm Ekkehard, Rajakannu Muthukumarassamy, Palaniappan Kumar, Rela Mohamed, Pawaria Arti, Rajakrishnan Haritha, Surendran Sudhindran, Kumar Mukesh, Agarwal Shaleen, Gupta Subhash, Asthana Sonal, Sakpal Mallikarjun, Avalareddy Ashritha, Spada Marco, Monti Lidia, Alterio Tommaso, Yanagi Yusuke, Uchida Hajime, Komine Ryuji, Evans Helen, Carr-Boyd Peter, Duncan David, Stefanowicz Marek, Latka-Grot Julita, Koleśnik Adam, Broering Dieter C, Raptis Dimitri A, Marquez Kris Ann H, Mali Vidyadhar, Aw Marion, Beretta Marisa, Van der Schyff Francisca, Quintero Jesús, Mercadal-Hally Maria, Molino-Gahete Jose Andrés, Andres Ane M, Hernandez-Oliveros Francisco, Remacha Esteban Frauca, Casswall Thomas, Jorns Carl, Delle Martin, Gupte Girish L, Sharif Khalid, McGuirk Simon P, Superina Riccardo, Caicedo Juan Carlos, Jaramillo Catalina, Bitterfeld Leandra, Kastenberg Zachary, Shah Amit A, Domenick Bryanna, Acord Michael R, Mazariegos George, Soltys Kyle, DiNorcia Joseph, Patel Puja, Florman Sander, Buchholz Bettina M, Herden Uta, Fischer Lutz, Dierckx Rudi A J O, Hartog Hermien, Van der Doef Hubert P J

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Аннотация

Guidelines for managing hepatic artery thrombosis (HAT) and stenosis (HAS) after pediatric liver transplantation (pLT) are lacking, with heterogeneous local practices. This study aims to evaluate management practices for HAT and HAS after pLT. An online and paper-based survey was sent to 36 international pLT centers. The survey included 36 questions covering center experience, screening protocols, diagnostic criteria, preventive management, post-procedural care, and follow-up. Treatment strategies were explored through hypothetical case scenarios categorized by early (≤14 d after pLT) and late onset complications (>14 d after pLT). Responses from 36 centers showed that 60% applied interrupted sutures and 76% used a surgical loupe during transplantation. In addition, 89% followed a specific anticoagulation protocol after uncomplicated pLT. All centers initiated Doppler ultrasound (DUS) within 24 hours after pLT, with 60% conducting it daily during the first week. Immediate re-transplantation was preferred for early HAT with pediatric acute liver failure (PALF) (61% vs. 11% for non-PALF, p <0.001), and surgical revascularization was more frequently chosen for non-PALF cases (51% vs. 24% for PALF, p <0.001). Endovascular therapy was selected in 35% of cases for both late HAT and HAS, with conservative management chosen in 51% for late HAT and 61% for late HAS (all p <0.001, compared to early cases). Internationally, there is agreement on the importance of early DUS screening in current management practices. Immediate re-transplantation was preferred for early HAT with PALF, while surgical revascularization was favored for non-PALF cases. Conservative management and endovascular therapy emerged as potential strategies for late-onset cases. This worldwide survey on real-world practice provides a basis for developing and implementing guidelines.

Для цитирования: Li Weihao, Bokkers Reinoud P H, Wildhaber Barbara E, Calinescu Ana M, Ricoeur Alexis, Marra Paolo, Bravi Michela, Pinelli Domenico, Minetto Julia, Dip Marcelo, Sierre Sergio, de Santibañes Martín, Ardiles Victoria, Uno Jimmy Walker, Hardikar Winita, Bates Sue, Goh Lynette, Aldrian Denise, Seisenbacher Jonathan, Vogel Georg F, Neto João Seda, da Fonseca Eduardo Antunes, Costa Carolina Magalhães, Ferreira Cristina T, Nader Luiza S, Farina Marco A, Dajani Khaled Z, Parente Alessandro, Bigam David L, Liang Tingbo, Bai Xueli, Xiang Jie, Gonsorčíková Lucie, Froněk Jiří, Bohuš Šimon, Franchi-Abella Stéphanie, Gonzales Emmanuel, Guérin Florent, Junge Norman, Baumann Ulrich, Richter Nicolas, Hartleif Steffen, Sturm Ekkehard, Rajakannu Muthukumarassamy, Palaniappan Kumar, Rela Mohamed, Pawaria Arti, Rajakrishnan Haritha, Surendran Sudhindran, Kumar Mukesh, Agarwal Shaleen, Gupta Subhash, Asthana Sonal, Sakpal Mallikarjun, Avalareddy Ashritha, Spada Marco, Monti Lidia, Alterio Tommaso, Yanagi Yusuke, Uchida Hajime, Komine Ryuji, Evans Helen, Carr-Boyd Peter, Duncan David, Stefanowicz Marek, Latka-Grot Julita, Koleśnik Adam, Broering Dieter C, Raptis Dimitri A, Marquez Kris Ann H, Mali Vidyadhar, Aw Marion, Beretta Marisa, Van der Schyff Francisca, Quintero Jesús, Mercadal-Hally Maria, Molino-Gahete Jose Andrés, Andres Ane M, Hernandez-Oliveros Francisco, Remacha Esteban Frauca, Casswall Thomas, Jorns Carl, Delle Martin, Gupte Girish L, Sharif Khalid, McGuirk Simon P, Superina Riccardo, Caicedo Juan Carlos, Jaramillo Catalina, Bitterfeld Leandra, Kastenberg Zachary, Shah Amit A, Domenick Bryanna, Acord Michael R, Mazariegos George, Soltys Kyle, DiNorcia Joseph, Patel Puja, Florman Sander, Buchholz Bettina M, Herden Uta, Fischer Lutz, Dierckx Rudi A J O, Hartog Hermien, Van der Doef Hubert P J. Management of hepatic artery thrombosis and stenosis after pediatric liver transplantation: Variability and agreement in management practices.. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2025. DOI: 10.1097/lvt.0000000000000671.

Предметные рубрики MeSH

Humans Liver Transplantation Hepatic Artery Child Thrombosis Constriction, Pathologic Practice Patterns, Physicians'Ultrasonography, Doppler Practice Guidelines as Topic Postoperative Complications Anticoagulants Reoperation Arterial Occlusive Diseases Health Care Surveys Surveys and Questionnaires Liver Failure, Acute

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