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Impact of localized ascites after pediatric living donor liver transplantation: report of three cases

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Abstract

Fluid collection is common after living donor liver transplantation (LDLT), and can include hematomas, bilomas, abscesses, and seromas. Although accumulated fluid rarely becomes infected and usually remains localized, localized ascites can sometimes be sufficiently extensive to induce vascular complications. This report presents three such cases in pediatric patients that underwent LDLT. A 33-month-old patient showed an increase in the volume of localized ascites around the hepatic vein anastomoses together with low hepatic vein flow on postoperative day (POD) 47. An 82-month-old patient showed an increase in the volume of localized ascites around the portal vein anastomoses together with low portal vein flow on POD 71. A 63-month-old patient showed an increase in the size of a localized abscess around the hepaticojejunostomy with dilatation of all of the intrahepatic bile ducts on POD 20. These cases illustrate the need for awareness of possible vascular or biliary complications due to compressive localized ascites after LDLT.

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Abbreviations

LT:

Liver transplantation

LDLT:

Living donor liver transplantation

BA:

Biliary atresia

OTCD:

Ornithine transcarbamylase deficiency

US:

Ultrasonography

CT:

Computed tomography

HV:

Hepatic vein

Tac:

Tacrolimus

MP:

Methylprednisolone

POD:

Postoperative day

TP:

Total protein

Alb:

Albumin

T.Bil:

Total bilirubin

HV-IVR:

Hepatic vein interventional radiology

PV:

Portal vein

PV-IVR:

Portal vein interventional radiology

IHBD:

Intrahepatic bile ducts

DBE-IVR:

Double balloon endoscopy interventional radiology

References

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Correspondence to Yukihiro Sanada.

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Sanada, Y., Urahashi, T., Ihara, Y. et al. Impact of localized ascites after pediatric living donor liver transplantation: report of three cases. Surg Today 44, 180–184 (2014). https://doi.org/10.1007/s00595-012-0358-7

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  • DOI: https://doi.org/10.1007/s00595-012-0358-7

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