} POCmUNAREL Concluslananutsertit dmsonstas tht ety initation of AOT can prevent pLT. and lesd twenmpletehepetoceliler regeneration in thi high isk groop of patents However, liver tansplanation mast be considered a an ealy stage because of an ‘ceria cure. of NHL Therefore, patens shouldbe vansfered toa pela liver ‘rasplantcemaeferfrter diagnosis and therapy iramediaey. Abstraitt 275 ANALYSIS OF FACTORS AFFECTING EARLY POSTOPERATIVE DOFPLER... ULTRASONOGRAPHY AFTER LIVER ‘TRANSPLANTATION. Jun Kadono,' Seigo Nishida, Tomoaki Keto,’ David M. Levi Juan R. Madariaga! Jang I. Moon,! Gennaro Selvaggi! Debbie Weppler! Pamela R. Dickson? Andreas G Teaks.! ‘Department af Surgery, Division of Transplantation, University of Miami, Miller School of Medicine, Miami, FL, USA; "Department of Radiology, University of Miani, Miller School of Medicine, Miami, FL, USA Background: Doppler ulrasonography (DUS) i uefa for detecting aril complication aftr liver ansplntation, However, predictive values of early osopeive DUS forthe subsequent development of arial complication and acs that fect sitive nde (RI remain cle, Methods: Fou hundred ninctesn (41 pediatric, 378 dak) ontop whole ver ‘eaplntaon repens ho had undergone DUS on Ist postoperative dey (POD) from 1998 to 2003 were analyzed respectively RI athe right hepa artery was valid. Type of aerial reconsaction was divided ino end-orend anesomoss ting ow hepatic artery and aahepatc bypass sing an atrial pat Done and fila age ere dived ft O18 19-40, 31-60, 6 RI war ide into, Law (Rle0., Normal (0.6:RIsD 8), High RI>08). Results: Pedic patents bad sigan’ lower RI compared tows (0720.12 5.06520 13, =0.000000), Younger donor group showed significantly lover RI Coxpaed oder rou inal (p=002577 Younger ecient group sho showed signicanty lower RI compared 1 older group in aul (9000062), Operation tm, Blood tansfusion and type of arr reconstruction didnt affect RU. cherie time dd no affec RI in ats; however High RI group ia pein pticns showed significa loner od ischemic ine (0.0560, Nincecn aril comphiations {adult 16, peda 3) developed. RI between ptiens with and wiou arterial conpliaion dao show deen. Inciene of terial complication Wasted tote Range ‘Concuslon:Peistic patiats bad signicaly lower RI compared to sts, Cold ‘scenic tne spd patients, donor and rete’ age feted Ron iPOD io pri areal complication by isl. Abstract# 276 PEDIATRIC IN SITU SPLIT LIVER TRANSPLANTATION FOR LANGERHANS’ CELL HISTIOCYTOSIS - ACUTE REJECTION AND DISEASE RECURRENCE, Marco Spada,’ Maurizio Aricd,? Davide Cintorino,' Sergio Clarizia,' Michela Guizzett,’ Alessandro Lucianett,’ Maria L. Melzi,’ Marida Minervini,’ Silvia Riva,! Aurelio Sonzogni,’ Paola Stroppa,’ Giuliano Torre,’ Michele Colledan,’ Bruno Gridelli.' ‘Surgery and Transplantation, ISMETT, Palermo, Italy: *Pediatric Oncology, Ospedale Civico, Palermo, Italy; ‘Livet Transplantation, Ospedali Riunii, Bergamo, Italy. Liver transplantation (LT) iss therapeutic option fo children with Langerbans’ cell histioeytonis(LCH) and end-stage liver disease ‘Between ‘97 and ‘04,256 children underwent LT, 239 in Bergamo and 17 in Palermo. ‘Three children (1.2) were affected by LCH, Median ages diagnosis was 4 mnths, Patents bad been diagnosed by skin oliver biopsy. Skin involvement, splenomagaly, ‘nd lymph node largement were presenti ll cldren, diabetes insipidus in 2, bone Jesions and lang involvement in I. All patients developed end-stage liver disease, ‘ith portal boss and bile duct proliferation and received chemotherapy. One child ‘was in remission pir to and had ative LCH. Medien age a LTx was 65 months; all children received # left atral segment from in sta split iver. The postT ‘munosoppesson included tacrolimus and steroids adn 2 cares basliximab, None ofthe patents developed acate collar rejection; 2 experienced bili stenosis, All 3 patients eave at median of 12 month, The child with LCH remision at Tx is currently asymptomatic, One patient developed LCH recurrence in the lungs ‘ontoning respiratory insufciecy 1 mooth after Tx, and was successfully teted with chemotherapy. ne third chil, 10 months pos-LTs, itaheptic LCH recurrence was diagnosed. LCH activity was initially controlled by chemotherapy but, as hemotherepy was stopped because of endocarditis, liver function test worsened and follow-up cholangiography demonstrated an high grade cholengiopathy, Patient is ised for reanmpimton. ‘An higher isk of sate rejection as been reported in LHC patients; oor patients had no rejection, Atv LCH at Tx are tisk of relapse tat can compromise graft fancion, 110 Abstracti# 27 DOPPLER ULTRASONOGRAPHY SCREENING AND PERCUTANEOUS BALLOON ANGIOPLASTY FOR HEPATIC ARTERY STENOSIS AFTER PEDIATRIC SPLIT LIVER TRANSPLANTATION. Angelo Luca, Marco Spada, Roberto Miraglia, Davide Cintorino, Gianluca Marrone, Sergio Clariza, Silvia Riva, Bruno Gridelli, Liver Transplantation, ISMETT, Palermo, Italy. Hepatic artery stenosis (HAS) and hepatic artery thrombosis are common and severe ‘complication after iver transplantation (Tx), We report our experince using Doppler lssonography (DUS) for the enly diagnosis of hepatic artery complications and percutaneous treatment of HAS ar pedro LT. nour protocol, DUS is performed daily forthe ist 5 day after Tx torue out hep tery complications Resistance index < 0.5 ervee andlor systole acceleration ime £2008 sec andlor velocity peak > 200 cm/sec ae sed as DUS criteria to suspect HAS. ‘16 slices mulidetecor CT (MDCT) with muhiplanar reconstructions, MIP, volume ‘tendering imaging, and digital subtraction angiogrephy ace used to confirm complications ‘Between 07103 and 40S, 20 pediatric Tx were performed. Median recipient age and \elaht were 5 years and 16 kg, respectively. DUS showed a suspicious of HAS in four ‘patents (205) al bat one id noma fiver funtion ets (LFTS). MDCT confirmed HAS in3 cases andinone showed a severe discrepancy between the donor and repent hepatic artery. The 4 patients received 3 lft lateral segment and one extended right grat ‘rom in stu split tver. Two patients with HAS were saccessfully treated With percutaneous balloon angioplasty In the hind case, we were not able to foes the senods. After a median follow up tine of 10 months, patients treated wih ballon angioplasty alive and well wit patent hepatic artery and normal LFTS, The patient ‘who underwent unsuccessful angioplasty developed small pseudoaneuris inthe Senotie tet likely due to the manipulation, is alive and well with normal LFTs, After pediatric Tx, DUS has high sesitivity in detecting early HAS, even in the seting of nomal LET, Percutaneous angioplasty i an effective teatment for HAS, ‘preventing hepatic artery thrombosis. ts usefuless, expecially i pi iver recipients ‘with complex vascular reconstuction, must be balanoed against the ik of seve Intogenie complications Abstract# 278 PEDIATRIC LIVER TRANSPLANTATION IN SHIRAZ ‘TRANSPLANT CENTER. Seyed-Ali Malek-Hossini, Heshmatollah Salahi, Ali Bahador, Mobammad-Hedi Imanieh, Alireza Mehdizadeb, ‘Mohammad-Hossein Anbarder, Ali Razmkon, Afsoon Fazelzadch, Reza Asadollahi. Shiraz Organ Transplant Center, Shiraz Medical School, Shiraz, Islamic Republic of Iran. Introdtion: Liver transplantation i a succesful and usefl therapy for children with cron ot end-tage iver disease and those with a variety of extrahepatic metabolic diseases that canbe conected by lverreplacement. Ith been done exclusively throughout anand Some neighboring counzies in our center for 12 years. ‘Materials and methods: ‘The first 150 consecutive liver tansplanstions were performed between April 14, 1993 and Feb 15,2005 in Shiraz (Souter Ira) organ tasplant center We evahted the 24 pediatric Tver transplantation revospecively, using the liver transplantation database, with a minimum fllow-ap period of 6 mont, esuls: Among 24 consecutive recipiems, 75% were male, and 25% were female (M/P=3) The average recipient age was 9.7 45 yeas (ange: 0.921015 yr) 15 patents had fl size cadaveric tanspla;8 patients received graft rom living donor. Only cass had splitlver transplantation. Te operative procedure was performed astandaré monet ‘sing du-o-dut anastomosis in 68% of the cases igayback technique was wtlizad in 90%, venovenous bypass in the rest. All cases were firs Inumunosuppressive regimen included Cellept,cylosporin end methylpredaslene Major causes of liver failure included cryptogenic (41.6%), eucimmune hepatis (20.8%), Biliary atresia 20.8%), Neonatal eitosis (12.5%) and biliary hypoplasia (4.3%), Rejection occurred in27% of eases once and 8% tvie. Most common shorter ‘complications included respiratory (12%) neurologic (10%) and blary (10%), Long term complications included rejection (9%) renal ale (6%) and death (15%). The «2+ and 3-year patient survival rates were 92%, 895, and 85%, respectively, Conctusior 1 Liver transplantation isthe preferred teatment fo end stage liver disease in pda patents, andi yielding acceptable results n our center comparable wth major word