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Surgical Complications Following Transplantation

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Book cover Pediatric Hepatology and Liver Transplantation

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Abstract

Surgical complications are common after pediatric liver transplantation, both in the early phase and in the follow-up, and can lead to graft loss or the patient’s death. Some of them are relatively uncommon but extremely serious, such as primary non-function of the graft, thrombosis of the hepatic artery or the portal vein, and acute outflow obstruction.

Others, like biliary leaks or strictures, are more frequent but more often successfully treated. Others again, as bleeding or bowel perforations, are less specific of the procedure itself and common to any abdominal surgery procedure.

The available data on risk factors, incidence, and outcome are contradictory, mostly due to the lack of homogeneous diagnosis and treatment criteria. Generally speaking, segmental grafts, strictly necessary in the pediatric field, seem to predispose to some complications, but in the majority of cases, the etiology is multifactorial, and their prevention requires high technical skills and a high level of accuracy.

Timing of management is crucial and requires systematically an early, often pre-symptomatic diagnosis. An aggressive multidisciplinary diagnostic and therapeutic approach is therefore the key for success in dealing with complications. This requires the constant availability of high surgical, interventional, and intensive care skills.

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Acknowledgments

We thank Dr. Roberto Agazzi for kindly providing the pictures of Figs. 30.1 and 30.2.

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Authors and Affiliations

  1. Department of Organ Failure and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy

    Michele Colledan, Domenico Pinelli & Laura Fontanella

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  1. Michele Colledan
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  2. Domenico Pinelli
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  3. Laura Fontanella
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Correspondence to Michele Colledan .

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Editors and Affiliations

  1. Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII Bergamo, Bergamo, Italy

    Lorenzo D'Antiga

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Colledan, M., Pinelli, D., Fontanella, L. (2019). Surgical Complications Following Transplantation. In: D'Antiga, L. (eds) Pediatric Hepatology and Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-96400-3_30

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