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Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations

Background: Pediatric liver surgery is a complex and challenging procedure and can be associated with major complications, including mortality. Best practices are not established. The aims of this study were to evaluate surgeons’ individual and institutional practices in pediatric liver surgery and...

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Autores principales: Lemoine, Caroline P., Madadi-Sanjani, Omid, Petersen, Claus, Chardot, Christophe, de Ville de Goyet, Jean, Superina, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179485/
https://www.ncbi.nlm.nih.gov/pubmed/37176667
http://dx.doi.org/10.3390/jcm12093229
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author Lemoine, Caroline P.
Madadi-Sanjani, Omid
Petersen, Claus
Chardot, Christophe
de Ville de Goyet, Jean
Superina, Riccardo
author_facet Lemoine, Caroline P.
Madadi-Sanjani, Omid
Petersen, Claus
Chardot, Christophe
de Ville de Goyet, Jean
Superina, Riccardo
author_sort Lemoine, Caroline P.
collection PubMed
description Background: Pediatric liver surgery is a complex and challenging procedure and can be associated with major complications, including mortality. Best practices are not established. The aims of this study were to evaluate surgeons’ individual and institutional practices in pediatric liver surgery and make recommendations applicable to the management of children who require liver surgery. Methods: A web-based survey was developed, focusing on the surgical management of children with liver conditions. It was distributed to 34 pediatric surgery faculty members of the Biliary Atresia and Related Disorders (BARD) consortium and 28 centers of the European Reference Network—Rare Liver. Using the Delphi method, a series of questions was then created to develop ideas about potential future developments in pediatric liver surgery. Results: The overall survey response rate was 70.6% (24/34), while the response rate for the Delphi questionnaire was 26.5% (9/34). In centers performing pediatric liver surgery, most pediatric subspecialties were present, although pediatric oncology was the least present (79.2%). Nearly all participants surveyed agreed that basic and advanced imaging modalities (including ERCP) should be available in those centers. Most pediatric liver surgeries were performed by pediatric surgeons (69.6%). A majority of participants agreed that centers treating pediatric liver tumors should include a pediatric transplant program (86%) able to perform technical variant grafts and living donor liver transplantation. Fifty-six percent of responders believe pediatric liver transplantation should be performed by specialized pediatric surgeons. Conclusion: Pediatric liver surgery should be performed by specialized pediatric surgeons and should be centralized in regional centers of excellence where all pediatric subspecialists are present. Pediatric hepatobiliary and transplant training needs to be better promoted amongst pediatric surgery fellows to increase this subspecialized workforce.
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spelling pubmed-101794852023-05-13 Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations Lemoine, Caroline P. Madadi-Sanjani, Omid Petersen, Claus Chardot, Christophe de Ville de Goyet, Jean Superina, Riccardo J Clin Med Article Background: Pediatric liver surgery is a complex and challenging procedure and can be associated with major complications, including mortality. Best practices are not established. The aims of this study were to evaluate surgeons’ individual and institutional practices in pediatric liver surgery and make recommendations applicable to the management of children who require liver surgery. Methods: A web-based survey was developed, focusing on the surgical management of children with liver conditions. It was distributed to 34 pediatric surgery faculty members of the Biliary Atresia and Related Disorders (BARD) consortium and 28 centers of the European Reference Network—Rare Liver. Using the Delphi method, a series of questions was then created to develop ideas about potential future developments in pediatric liver surgery. Results: The overall survey response rate was 70.6% (24/34), while the response rate for the Delphi questionnaire was 26.5% (9/34). In centers performing pediatric liver surgery, most pediatric subspecialties were present, although pediatric oncology was the least present (79.2%). Nearly all participants surveyed agreed that basic and advanced imaging modalities (including ERCP) should be available in those centers. Most pediatric liver surgeries were performed by pediatric surgeons (69.6%). A majority of participants agreed that centers treating pediatric liver tumors should include a pediatric transplant program (86%) able to perform technical variant grafts and living donor liver transplantation. Fifty-six percent of responders believe pediatric liver transplantation should be performed by specialized pediatric surgeons. Conclusion: Pediatric liver surgery should be performed by specialized pediatric surgeons and should be centralized in regional centers of excellence where all pediatric subspecialists are present. Pediatric hepatobiliary and transplant training needs to be better promoted amongst pediatric surgery fellows to increase this subspecialized workforce. MDPI 2023-04-30 /pmc/articles/PMC10179485/ /pubmed/37176667 http://dx.doi.org/10.3390/jcm12093229 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lemoine, Caroline P.
Madadi-Sanjani, Omid
Petersen, Claus
Chardot, Christophe
de Ville de Goyet, Jean
Superina, Riccardo
Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations
title Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations
title_full Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations
title_fullStr Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations
title_full_unstemmed Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations
title_short Pediatric Liver and Transplant Surgery: Results of an International Survey and Expert Consensus Recommendations
title_sort pediatric liver and transplant surgery: results of an international survey and expert consensus recommendations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179485/
https://www.ncbi.nlm.nih.gov/pubmed/37176667
http://dx.doi.org/10.3390/jcm12093229
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