肝移植和未接受肝移植的儿童门静脉分流的效果。

IF 1.3 Q3 PEDIATRICS Pediatric Gastroenterology, Hepatology & Nutrition Pub Date : 2024-01-01 Epub Date: 2024-01-09 DOI:10.5223/pghn.2024.27.1.37
Hamza Hassan Khan, Stuart S Kaufman, Nada A Yazigi, Khalid M Khan
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引用次数: 0

摘要

目的:有关儿科移植人群门静脉系统分流术的疗效和发病率的数据有限。我们的研究评估了接受门静脉分流术的儿科患者的治疗效果,包括肝移植(LT)和非肝移植(LT):本研究回顾性审查了一家三级医疗中心在2003年至2017年间接受分流术的0-19岁儿科患者的病历。结果:共纳入13名儿科患者:研究共纳入13名儿科患者,中位年龄为8.8岁。其中,13 例中有 11 例(84.6%)接受了脾肾分流术,1 例(7.7%)接受了腔中分流术,另有 1 例(7.7%)接受了改良雷克斯(门脉间)分流术。此外,13 名患者中有 5 人(38.5%)接受了 LT,其中 4 人(80.0%)在分流术前接受了移植,1 人(20.0%)在分流术后接受了移植。门静脉高压导致的消化道出血是所有病例的适应症。5 名患者共出现了 10 种并发症,其中最常见的并发症是贫血,有 3 名患者(23.1%)出现了贫血。在最近的随访中,分流器功能正常,没有出现脑病,也没有死亡报告:结论:分流管置入术在门静脉高压症患者的治疗中起着至关重要的作用。我们的研究表明,接受分流术的儿童患者长期疗效良好。LT患者和未接受LT治疗的患者的长期分流效果相似且无显著差异。
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Outcomes of Portosystemic Shunts in Children with and without Liver Transplantation.

Purpose: Limited data exist regarding outcome and morbidity associated with portosystemic shunts in the pediatric transplant population. Our study assesses the outcomes of pediatric patients who underwent a portosystemic shunt procedure, both with and without liver transplantation (LT).

Methods: This study retrospectively reviewed the medical records of pediatric patients aged 0-19 years who underwent shunt placement between 2003 and 2017 at a tertiary care center. The analysis included cases of shunt placement with or without LT.

Results: A total of 13 pediatric patients were included in the study with median age of 8.8 years. Among the cases, 11 out of 13 (84.6%) underwent splenorenal shunt, 1 (7.7%) underwent a mesocaval shunt, and another 1 (7.7%) underwent a Modified Rex (mesoportal) shunt. Additionally, 5 out of 13 (38.5%) patients had LT, with 4 out of 5 (80.0%) receiving the transplant before shunt placement, and 1 out of 5 (20.0%) receiving it after shunt placement. Gastrointestinal bleeding resulting from portal hypertension was the indication in all cases. A total of 10 complications were reported in 5 patients; the most common complication was anemia in 3 (23.1%) patients. At the most recent follow-up visit, the shunts were functional without encephalopathy, and no deaths were reported.

Conclusion: Shunt placement plays a crucial role in the management of patients with portal hypertension. Our study demonstrates favorable long-term outcomes in pediatric patients who underwent shunt placement. Long term shunt outcomes were similar and unremarkable in patients with LT and without LT.

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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
43
期刊介绍: Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.
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