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Liver transplantation in infants.
1Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong.
Journal of Pediatric Surgery
|December 11, 1999
Summary
Pediatric liver transplantation in infants under one year is challenging but achievable, demonstrating high survival rates. This study suggests that young age should not preclude infants from receiving life-saving liver transplants.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplant Surgery
Background:
- Infants under one year are considered a high-risk group for liver transplantation.
- Previous reports highlight the challenges associated with performing liver transplants in this age demographic.
Purpose of the Study:
- To review the experience of orthotopic liver transplantation in children younger than one year.
- To evaluate the feasibility and outcomes of liver transplantation in this high-risk pediatric population.
Main Methods:
- Retrospective review of 9 children under one year who underwent liver transplantation.
- Procedures included 6 living-related liver transplants and 3 reduced-size liver transplants.
- Transplantations were performed between December 1993 and June 1997.
Main Results:
- Five reoperations were required due to early complications such as bleeding and anastomotic leakage.
- Late complications included biliary-enteric strictures and hepatitis requiring retransplantation.
- Excellent outcomes were observed: 100% patient survival and 89% graft survival with good liver function; no hepatic artery thrombosis occurred.
Conclusions:
- Liver transplantation in infants under one year is technically demanding but feasible.
- The procedure can be performed with good outcomes, indicating age alone should not be a contraindication.
- This study supports the consideration of liver transplantation for infants regardless of age.