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Published on: August 17, 2022
Pediatric liver transplant: results of a single center
Mehmet Haberal1, Sinasi Sevmis, Hamdi Karakayali
1Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey. rektorluk@baskent-ank.edu.tr
Insights
Pediatric liver transplantation outcomes are promising, with 85% of children alive and functioning grafts after a median of 24 months. Survival rates reached 83% at 36 months post-transplant.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplantation Medicine
Background:
- Liver transplantation is a vital treatment for pediatric end-stage liver disease.
- Advancements have made pediatric liver transplant an accepted modality.
Purpose of the Study:
- To analyze the center's experience with pediatric liver transplantation.
- To evaluate outcomes and complications in children undergoing liver transplant.
Main Methods:
- Retrospective review of 101 pediatric liver transplants (8 deceased-donor, 96 living-donor) performed since September 2001.
- Analysis of patient demographics, indications, complications, and survival rates.
Main Results:
- Common indications included biliary atresia (n=24) and fulminant liver failure (n=18).
- Major complications involved infections (25.9%) and surgical issues (39.5%).
- Patient survival rates were 90% at 6 months, 85% at 12 months, and 83% at 36 months, with 85% of recipients alive with functioning grafts.
Conclusions:
- Pediatric liver transplantation at this center demonstrates promising outcomes.
- High survival rates and good graft function support the efficacy of the procedure in children.
Objectives:
Liver transplant in the pediatric population has become an accepted treatment modality for children with end-stage liver disease. In this study, we analyze our experiences with pediatric liver transplant at our center.
Materials And Methods:
Since September 2001, 8 deceased-donor and 96 living-donor liver transplants have been done in 101 children (mean age, 6.7 +/- 5.5 years; range, 2 months to 17 years). The children's charts were reviewed retrospectively.
Results:
Indications for liver transplant were cholestatic liver disease (n=17), biliary atresia (n=24), Wilson's disease (n=16), fulminant liver failure (n=18), hepatic tumor (n=13), and other (n=13). The median pediatric end-stage liver disease score was 23.1 +/- 11.1 (range, -8 to 48). The median follow-up was 24.2 +/- 19.4 months (range, 1-77 months). Three children underwent retransplant. The main complications were infections (25.9%) and surgical complications (39.5%) (including biliary complications and vascular problems). The incidence of acute cellular rejection was 42.3%. Sixteen children died during follow-up, and, at the time of this writing, the remaining 85 children (85%) were alive with good graft functioning, showing patient survival rates of 90%, 85%, and 83% at 6, 12, and 36 months, respectively.
Conclusions:
In conclusion, the overall outcomes of pediatric liver transplantation at our center are quite promising.
