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Updated: Aug 14, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
Pediatric liver transplantation: ten years of experience in a multicentric program in Chile
M Uribe1, E Buckel, M Ferrario
1Programa Trasplante Hepático Clinica las Condes, Hospital Luis Calvo Mackenna, Lo Fontecilla 441, Las Condes, Santiago, Chile. muribemd@hotmail.com
Insights
Pediatric liver transplantation in Chile, initiated in 1993, achieved 81.3% graft survival at 1 year and 72% at 5 years. This study details outcomes for 132 pediatric liver transplants, focusing on indications and complications.
Area of Science:
- Pediatric surgery
- Hepatology
- Transplant immunology
Background:
- Liver transplantation is the sole curative option for end-stage liver disease in children.
- Chile initiated its pediatric liver transplant program in 1993, contributing to global advancements in the field.
Purpose of the Study:
- To present the experience and outcomes of pediatric liver transplantation performed in Chile between 1993 and 2004.
- To analyze indications, surgical techniques, complications, and survival rates in pediatric liver transplant recipients.
Main Methods:
- Retrospective analysis of 132 pediatric orthotopic liver transplants (OLT) performed from 1993 to 2004.
- Detailed review of patient demographics, indications (biliary atresia, acute liver failure), surgical procedures (complete, reduced, split, auxiliary, living-related grafts), vascular and biliary reconstruction techniques, immunosuppression protocols, and complication rates.
- Actuarial graft survival analysis was performed.
Main Results:
- The most common indications were biliary atresia (43.1%) and acute liver failure (20.4%).
- Biliary complications (21.4%) and vascular complications (13%) were the most frequent issues. 66 patients experienced acute rejection.
- Actuarial graft survival was 81.3% at 1 year and 72% at 5 years. For acute liver failure, survival was 75.9% at 1 year and 67.8% at 5 years.
Conclusions:
- Pediatric liver transplantation in Chile yielded results comparable to international standards.
- The program demonstrated successful management of indications, complications, and immunosuppression in pediatric liver transplant recipients.
- Long-term graft survival rates support the efficacy of the established protocols.
Abstract:
Liver transplantation is the only treatment for patients with terminal acute and chronic diseases. Liver transplantation was started in Chile in 1985; our pediatric program began in 1993. The aim of this paper work was to present our experience from 1993 through 2004. One hundred and thirty two orthotopic liver transplants (OLT) were performed in children of mean age 5 years and median age 4 years (8 months to 15 years). The most frequent indications were biliary atresia, (43.1%) and acute liver failure (ALF; 20.4%), whose frequent cause was unknown but viral hepatitis A was the second one. A complete liver was transplanted in 59 patients, reduced in 39, split in one, and as an auxiliary liver in another one. Living related liver transplantation was performed in 32 cases (24.2%), of which thirty included segments II and III, and two, a right liver. A terminal arterial anastomosis was performed in 102 (77.2%) recipients and a graft interposition in 32 patients (24.2%). In 16 cases, biliary reconstruction was performed through an enterobiliary anastomosis. Immunosuppression included cyclosporine (Neoral), steroids, and azathioprine with conversion to tacrolimus (Prograf) as indicated. Rejection episodes, which were always biopsy-proven, were treated either with methylprednisolone or with antibodies. Biliary complications were the most frequent (21.4%) and the second cause was vascular complications (13%). Sixty-six patients suffered an acute rejection episode. Actuarial graft survival was 81.3% at 1 year and 72% at 5 years, while actuarial graft survival for ALF was 75.9% at 1 year and 67.8% at 5 years. Our results are comparable to those reported by most international groups.
