REX SHUNT FOR ACUTE PORTAL VEIN THROMBOSIS AFTER PEDIATRIC LIVER TRANSPLANT IN CHILDREN WITH BILIARY ATRESIA

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGIBELLI, Nelson Elias Mendes
dc.contributor.authorANDRADE, Wagner de Castro
dc.contributor.authorVELHOTE, Manoel Carlos Prieto
dc.contributor.authorAYOUB, Ali Abdul Rahman
dc.contributor.authorSILVA, Marcos Marques da
dc.contributor.authorPINHO-APEZZATO, Maria Lucia de
dc.contributor.authorTANNURI, Ana Cristina Aoun
dc.contributor.authorBARROS, Fabio de
dc.contributor.authorRICARDI, Luis Roberto Schlaich
dc.contributor.authorMOREIRA, Daniel de Albuquerque Rangel
dc.contributor.authorMIYATANI, Helena Thie
dc.contributor.authorPEREIRA, Paulo Renato Alencar
dc.contributor.authorTANNURI, Uenis
dc.date.accessioned2013-10-11T21:15:09Z
dc.date.available2013-10-11T21:15:09Z
dc.date.issued2013
dc.description.abstractBACKGROUND/PURPOSE: zPost transplant portal vein thrombosis (PVT)can be extremely disastrous, and portal hypertension and other consequences of the long term privation of portal inflow to the graft may be hazardous, especially in the very young children. Since 1998, Rex shunt has been used successfully to treat these patients. In 2007 we started to perform this surgery in patients with idiopathic PVT and late post transplant PVT. We report our experience with this technique in acute post transplant PVT. METHODS: Case report of six patients (age–12–18 months) submitted to cadaveric (1) and living donor (5) liver transplant (LT). All patients had biliary atresia with portal vein hipoplasia and developed acute portal vein thrombosis (PVT) in the first post-operative day. They were submitted to a mesenteric-portal surgical shunt (Rex shunt) with left internal jugular vein autograft (5) and cadaveric iliac vein graft (1) in the first post-operative day. RESULTS: Current follow-up of 12 months. Postoperative Doppler ultrasounds confirmed shunt patency. There were no biliary complications until now. CONCLUSION: The mesenteric-portal shunt (Rex shunt) with left internal jugular vein autograft should be considered in children with acute PVT after liver transplantation. These children usually have small portal veins, and reanastomosis is often unsuccessful. In addition, this technique has the advantage that we do not manipulate the biliary anastomosis and the hepatic hilum, thus avoiding biliary complications. Although this is an initial experience, we conclude that this technique is feasible, with great benefits for these patients and with low risks.
dc.description.conferencedateNOV 08-09, 2012
dc.description.conferencelocalSao Paulo, BRAZIL
dc.description.conferencename1st Brazilian Symposium of Pediatric Transplantation
dc.description.indexMEDLINE
dc.identifier.citationPEDIATRIC TRANSPLANTATION, v.17, n.2, p.195-195, 2013
dc.identifier.doi10.1111/petr.12037
dc.identifier.issn1397-3142
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/2650
dc.language.isoeng
dc.publisherWILEY-BLACKWELL
dc.relation.ispartofPediatric Transplantation
dc.rightsrestrictedAccess
dc.rights.holderCopyright WILEY-BLACKWELL
dc.subject.wosPediatrics
dc.subject.wosTransplantation
dc.titleREX SHUNT FOR ACUTE PORTAL VEIN THROMBOSIS AFTER PEDIATRIC LIVER TRANSPLANT IN CHILDREN WITH BILIARY ATRESIA
dc.typeconferenceObject
dc.type.categorymeeting abstract
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalRICARDI, Luis Roberto Schlaich:Univ Sao Paulo, Fac Med, Pediat Surg & Liver Transplantat Div, Dept Pediat,Hosp Clin,Inst Crianca, Sao Paulo, Brazil
hcfmusp.contributor.author-fmusphcNELSON ELIAS MENDES GIBELLI
hcfmusp.contributor.author-fmusphcWAGNER DE CASTRO ANDRADE
hcfmusp.contributor.author-fmusphcMANOEL CARLOS PRIETO VELHOTE
hcfmusp.contributor.author-fmusphcALI ABDUL RAHMAN AYOUB
hcfmusp.contributor.author-fmusphcMARCOS MARQUES DA SILVA
hcfmusp.contributor.author-fmusphcMARIA LUCIA DE PINHO APEZZATO
hcfmusp.contributor.author-fmusphcANA CRISTINA AOUN TANNURI
hcfmusp.contributor.author-fmusphcFABIO DE BARROS
hcfmusp.contributor.author-fmusphcDANIEL DE ALBUQUERQUE RANGEL MOREIRA
hcfmusp.contributor.author-fmusphcHELENA THIE MIYATANI
hcfmusp.contributor.author-fmusphcPAULO RENATO DE ALENCAR PEREIRA
hcfmusp.contributor.author-fmusphcUENIS TANNURI
hcfmusp.description.beginpage195
hcfmusp.description.endpage195
hcfmusp.description.issue2
hcfmusp.description.volume17
hcfmusp.origemWOS
hcfmusp.origem.wosWOS:000315467000035
hcfmusp.publisher.cityHOBOKEN
hcfmusp.publisher.countryUSA
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Coleções
Comunicações em Eventos - FM/MCG
Comunicações em Eventos - FM/MPE
Comunicações em Eventos - HC/ICr
Comunicações em Eventos - LIM/26
Comunicações em Eventos - LIM/30