https://pubmed.ncbi.nlm.nih.gov/34428333/ Liver Transplantation

Pediatr Transplant. 2021 Aug 24;e14123.
doi: 10.1111/petr.14123. Online ahead of print.

The diagnosis and management of intestinal obstruction after pediatric liver transplantation

Chao Sun 1 2 3, Zhuolun Song 1 2 3, Chong Dong 1 2 3, Weiping Zheng 1 2 3, Kai Wang 1 2 3, Hong Qin 1 2 3, Yang Yang 1 2 3, Chao Han 1 2 3, Fubo Zhang 1 2 3, Min Xu 1 2 3, Shunqi Cao 1 2 3, Yu Cao 1 2 3, Wei Gao 1 2 3, Zhongyang Shen 1 2 3

Abstract
Background: The aim of this study was to analyze the risk factors, causes, and management of intestinal obstruction after pediatric liver transplantation.
Methods: Retrospective analysis was performed on pediatric liver transplantation recipients from January 1st 2013 to December 31st 2019 at Organ Transplant Center, Tianjin First Central Hospital. The cases of intestinal obstruction were analyzed.

Results: A total of 1034 pediatric liver transplantations were performed during the study period, 66 intestinal obstructions were diagnosed in 61 recipients. Three recipients suffered intestinal obstructions twice, and one recipient suffered three times. Forty of the 66 cases were treated with non-surgical treatment, including fasting, gastrointestinal decompression, purgation, enema, and parenteral nutrition. Surgical intervention was performed in 26 cases. Diaphragmatic hernia, intestinal inflammatory stenosis, PTLD, and intestine perforation are essential causes of intestinal obstruction in pediatric liver transplant recipients. Diaphragmatic hernia was independent risk factors for intestinal obstruction. The 1-, 2- and 3-year survival rate of the recipients with or without intestinal obstruction were 98.4%, 96.5%, 96.5% and 95.3%, 94.4%, 94.0%, respectively, without significant difference.

Conclusions: Most cases of intestinal obstruction after liver transplantation in children can be remitted by non-surgical treatment, but there are still some cases need to be treated by surgery. Both measures are related to ideal outcomes, intestinal obstruction does not increase the mortality rate in pediatric liver transplantation.