Use of split-liver allografts does not impair pediatric recipient growth

Area of Science:

• Pediatric surgery
• Transplantation immunology
• Pediatric gastroenterology

Background:

• Split-liver (SL) allografts are a viable option for pediatric liver transplantation.
• Patient and graft survival rates for SL allografts are comparable to whole organ grafts.
• Limited data exists on the long-term quality of life, specifically growth, in pediatric SL recipients compared to whole-graft recipients.

Purpose of the Study:

• To compare the linear growth of pediatric liver transplant recipients using split-liver (SL) allografts versus whole-size allografts.
• To evaluate height z scores and catch-up growth in young children post-transplantation.

Main Methods:

• A retrospective analysis of 201 pediatric liver transplants performed between 1995 and 2004 at two institutions.
• Data collection included height, z score, and delta z score for 39 split-graft and 36 whole-size recipients aged 3 years or younger at transplant.
• Statistical analysis of height z scores at 1, 2, and 3 years post-transplant.

Main Results:

• All recipients experienced growth retardation at the time of transplant.
• No statistically significant differences in height z scores were observed between SL and whole-size graft recipients at 1, 2, and 3 years post-transplant (P = 0.65, 0.13, and 0.32, respectively).
• Catch-up growth was observed exclusively in recipients of split grafts.

Conclusions:

• Split-liver transplantation does not significantly impair linear growth in pediatric recipients compared to whole-size grafts.
• SL allografts demonstrate comparable growth outcomes to conventional whole organ grafts.
• The findings suggest that SL transplantation is a safe and effective option for pediatric liver recipients, supporting satisfactory growth trajectories.