Surgical complications in children after liver transplantation

Ron Bilik, M. Yellen, Riccardo A. Superina*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


The frequency of surgical complications after liver transplantation remains high. Sixty transplants were done in 48 patients during years. Eleven patients were retransplanted (retransplant rate, 20%) for primary nonfunction (6), arterial thrombosis (3), warm ischemia (1), and rejection (2). Right pleural effusions were drained in 13 patients and left ones in 2. Forty-eight reexplorations excluding retransplantation were performed in 20 patients. Twelve laparotomies were for control of postoperative intraabdominal bleeding. The majority of these patients ( 8 10, 80%) were transplanted with reduced-size grafts. Early postoperative vascular complications were detected in 12 grafts (5 portal vein occlusions, 7 arterial thromboses). All 5 patients with portal vein (PV) occlusions were reexplored, and PV flow was reestablished in all 5. Biliary leaks were diagnosed in 6 patients and were associated with arterial thromboses in 2 cases. Reoperation was required in 4 of 6 patients. Bowel perforation occurred in 4 patients: 2 small bowel, 1 duodenum, and 1 colon. There was 1 postoperative bowel obstruction requiring laparotomy. Two splenectomies were required in 4 patients with splenic infarction. Resection of part of a transplanted liver was done in 1 patient to exclude septic infarcts. Pancreatitis was diagnosed in 4 patients and one required laparotomy for control of pancreatic hemorrhage. Intraabdominal abscesses required open drainage in 2 patients and percutaneous drainage in 4. Seven thoracotomies were done in 6 patients: 5 open lung biopsies, 1 for control of hemorrhage, and 1 for diaphragmatic plication. The current high survival rates following liver transplantation require aggressive surgical management of a myriad of complications and numerous procedures are necessary both as treatment modalities and as diagnostic aids.

Original languageEnglish (US)
Pages (from-to)1371-1375
Number of pages5
JournalJournal of pediatric surgery
Issue number11
StatePublished - Nov 1992


  • Liver
  • pediatric
  • transplantation

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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