The charts of 99 first liver transplant recipients under 18 years of age who underwent DDLT at the Hospital de Clínicas de Porto Alegre between March of 1995 and November of 2009 were retrospectively reviewed. The study was approved by the institution’s ethics committee. During this period, 128 liver transplants were performed on 121 children and adolescents (range: 4 months to 18 AZD2281 clinical trial years). Of these, 29 were excluded from the sample: 13 who underwent emergency liver transplantation due to fulminant hepatitis, six who received living donor grafts, and three because the preservation solution wasn’t

the University of Wisconsin solution (UW). The exclusion criteria were defined in order to avoid comparison bias based on immunological or technical factors influencing vascular complications. The patients were split into two groups for comparison: with vascular complications (n = 19) and without vascular complications (n = 88). These data were used for univariate and multivariate analysis in order to identify the associated factors. Recipients were assessed for the following variables: age, gender, weight, transplant indication, PELD/MELD scores, type of allograft, type of anastomosis, vascular complications, management of these Tenofovir clinical trial complications, and survival. Since data regarding graft weight was not available for all patients, the donor weight/recipient weight ratio (DRWR)

was assessed.5 The diagnosis of vascular complications was established by a minimum of two imaging modalities and/or surgical confirmation. All transplants were performed by the same surgical team, and the piggyback technique with vena cava preservation was the standard procedure. Vascular anastomosis was performed under 3.5 × loupe magnifications. A PDS™ (Ethicon) (7‐0 polydioxanone monofilament) thread was used for arterial and portal sutures, and a non‐absorbable 5‐0

polypropylene monofilament was used on the hepatic veins. Running stitches were used for vessels larger than 3 mm in diameter, and simple interrupted stitches for smaller vessels. Postoperatively, blood flow in the hepatic artery, portal vein, Amino acid and suprahepatic vena cava was assessed by Doppler ultrasonography (DUS) of the abdomen once a day during the first postoperative week; every other day on the second week; and once a week subsequently, for a total of 30 days. Outpatient DUS follow‐up was provided on the third and sixth postoperative months, and one year after transplantation. DUS was subsequently performed once a year or when patients developed clinical and/or biochemical abnormalities that justified testing. When DUS suggested a vascular complication, repeat ultrasound, angiography, computerized tomography (CT) scan with intravenous contrast, and/or surgery was performed to confirm or discard the diagnosis. Vascular complications were classified as arterial (hepatic artery) or venous (affecting the portal vein or suprahepatic vena cava).