Clinical analysis of different surgical approaches of portal vein reconstruction in pediatric living-related liver transplantation for 45 infant patients with biliary atresia

Objective To summarize the postoperative portal vein complications (PVC) in infant patients with biliary atresia (BA) undergoing living-related liver transplantation (LRLT) by different procedures of portal vein reconstruction. Method Retrospective analyses were performed on 45 infant patients with biliary atresia undergoing living-related liver transplantation from June 2013 to July 2014. The relationship between the procedure of portal veins reconstruction and occurrence of portal vein complications was analyzed. Among them, 28 cases underwent the branch patch technique to reconstruct the portal vein, 8 cases underwent portal vein reconstruction with an interposition vein graft, and the rest 9 cases underwent the modified end to end anastomosis to reconstruct the portal vein. Result Of the 45 cases, 3 cases experienced PVC in the postoperative period, and the occurrence rate of PVC was 6.67% (3/45). In the branch patch group, portal vein stenosis (PVS) occurred in 1 case. In the IVG group, 1 case developed PVS, and the other developed portal vein thrombosis (PVT). No PVCs were observed in the MEA group. The occurrence rate of PVC in BP, IVG and MEA groups was 3.57%, 25% and 0, respectively. The occurrence rate of PVC in MEA group was lower than in the other groups, and that in the IVG group was higher than in the other groups, but the difference was not significant (P>0.05). Conclusion The modified end to end anastomosis appears to be a feasible option with less PVC when performing LRLT for infant patients with biliary atresia, while the interposition vein graft may increase the risk of PVC occurrence. Key words: Infant patients; Biliary atresia; Liver transplantation; Portal vein reconstruction; Complications