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Published on: May 23, 2025
[Management of pediatric patients who underwent liver transplantation]
Zhong-Lin Wang1, Xiao-Hong Wang, Shan Zheng
1Department of Infectious Diseases, Pediatric Hospital, Fudan University, Shanghai 200032, China.
Insights
Pediatric liver transplantation outcomes show a 75% one-year survival rate. Close patient management is key to improving survival and quality of life for children with end-stage liver disease.
Area of Science:
- Pediatric Hepatology
- Transplantation Surgery
- Immunology
Context:
- Liver transplantation is a critical treatment for end-stage liver disease in children.
- Outcomes in pediatric liver transplantation require careful evaluation.
- This study focuses on outcomes from 2002-2005 at a dedicated Pediatric Hospital.
Purpose:
- To evaluate the outcomes of pediatric liver transplantation.
- To assess survival rates, complications, and quality of life post-transplantation.
- To identify factors influencing success in pediatric liver recipients.
Summary:
- Retrospective analysis of eight pediatric patients (4 months to 67 months) undergoing liver transplantation for various liver diseases.
- One-year survival rate was 75%, with complications including rejection, viral infections (CMV, EBV, HBV), and surgical issues.
- Tacrolimus side effects were noted, but significant growth retardation was uncommon, and quality of life was generally reported as good.
Impact:
- Highlights the importance of rigorous post-transplant monitoring and management in pediatric liver recipients.
- Demonstrates that successful liver transplantation can significantly improve survival and quality of life for children with end-stage liver disease.
- Provides insights into common complications and side effects, aiding in future clinical management strategies.
Objective:
To evaluate the outcome of pediatric patients who underwent liver transplantation between Oct. 2002 and May 2005 in the Pediatric Hospital.
Methods:
Eight cases aged from 4 to 67 months who underwent liver transplantation were analyzed retrospectively. Four of the patients were boys and 4 girls, whose body weight at the time of liver transplantation was 6-19 kg. The underlying diseases were biliary atresia, congenital cholestasis, drug-induced cholestatic cirrhosis and cryptogenic cirrhosis. These patients had been followed up for blood routine examinations, liver and renal function, serum electrolytes and blood concentration of tacrolimus for 16 to 43 months after liver transplantation. Results of serological studies for viral etiology, liver biopsy, growth and mental development were also recorded.
Results:
One-year survival rate was 75.0% with the longest survival time being 43 months after transplantation. One patient died from renal failure due to postoperative bleeding 24 hours after the surgery and another case died of variceal hemorrhage 8 months after transplantation. Posttransplantation complications included acute cellular rejection, viral infection and hypoalbuminemia. Viral infections included cytomegalovirus infection in 3 cases, Epstein-Barr virus infection in 1 and hepatitis B virus infection in 1. Surgical complications of portal vein thrombosis and stenosis of inferior vena cava and hepatic vein occurred in 2 cases respectively. Side effects of tacrolimus including hypertension, renal damage, liver damage and diarrhea were observed. Significant growth-retardation was not often seen. A self-reported high quality of life was common.
Conclusions:
Close follow-up and management of patients after liver transplantation may significantly increase the survival rate and improve quality of life in children with end-stage liver diseases.
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