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Living-related liver transplantation in pediatric patients
1Baskent University Hospital, Department of General, Surgery Ankara, Turkey.
Insights
Pediatric liver transplant outcomes show promising survival rates, with 92.3% of patients undergoing living-related transplants. Early results indicate good graft function despite complications like infections and vascular issues.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplantation Medicine
Background:
- Advancements in surgical techniques, immunosuppression, and patient selection have improved outcomes for pediatric liver transplant recipients.
- This study retrospectively analyzed early results from 26 pediatric liver transplantations performed between 2003 and 2004.
Purpose of the Study:
- To evaluate the early outcomes of liver transplantation in pediatric patients.
- To assess patient and graft survival rates, and identify common morbidities.
Main Methods:
- Retrospective review of medical records for 26 pediatric liver transplant recipients.
- Analysis of indications for transplantation, type of transplant (living-related vs. cadaveric), survival rates, and complications.
Main Results:
- The most common indications were cholestasis (38.5%) and Wilson's disease (30.8%).
- Living-related liver transplantation was performed in 92.3% of cases.
- Patient and graft survival rates were 91.2% at 3 months, 86.4% at 12 months, and 81.6% at 24 months.
- Common morbidities included biliary and vascular complications (15.3% each for bile leaks and hepatic artery thromboses), and severe infections (19.2%).
Conclusions:
- Pediatric liver transplantation demonstrated promising early results at the institution, despite challenges.
- High survival rates were achieved, but careful management of complications is crucial.
Introduction:
Many developments in surgical technique, immunosuppression, and patient selection criteria have led to improved long-term patient and graft survival in pediatric patients receiving liver transplants. In this study, we examined the early results of 26 pediatric recipients who underwent 26 liver transplantations between January 2003 and December 2004 at our institution.
Materials And Methods:
The most common indications for liver transplantation were cholestasis in 10 patients (38.5%) and Wilson's disease in 8 (30.8%). Other indications were fulminant hepatic failure (4 patients, 15.4%), tyrosinemia (2 patients, 7.7%), Caroli disease (1 patient, 3.8%), and cryptogenic cirrhosis (1 patient, 3.8%). One recipient with Byler disease and two with tyrosinemia also had incidental hepatocellular carcinoma.
Results:
Of 26 patients, 24 (92.3%) underwent living-related liver transplantation and 2 (7.7%) underwent cadaveric transplantation. The medical records of all patients were retrospectively reviewed. Twenty-two of 26 survived with excellent graft function, showing 91.2%, 86.4%, and 81.6% at 3, 12, and 24 months graft and patient survival rates, respectively. Sixteen patients (61.5%) developed various morbidities with biliary and vascular complications being the most common. Four patients (15.3%) developed bile leaks. Four patients (15.3%) developed hepatic artery thromboses. Five patients (19.2%) developed life-threatening infections. Four patients (15.4%) died during the study period, three owing to infectious complications. The other patient died due to acute respiratory distress syndrome.
Conclusion:
Despite technical difficulties and a donor organ shortage, the results of liver transplantation in pediatric patients with end-stage liver disease have demonstrated promising results at our institution.
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