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Pediatric liver transplantation in Hong Kong-a domain with scarce deceased donors
Kwong Leung Chan1, Sheung Tat Fan, Chung Mau Lo
1Department of Surgery, The University of Hong Kong, Hong Kong, China.
Insights
Live-donor liver transplants offer a viable solution for pediatric patients facing donor scarcity. This study demonstrates comparable survival rates between living-related and deceased-donor liver transplants, highlighting the success of LRLTs.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplantation Medicine
Background:
- Limited access to deceased organ donors poses a significant challenge for pediatric liver transplantation.
- Live-donor liver transplantation (LDLT) presents a potential alternative in regions with donor shortages.
Purpose of the Study:
- To evaluate the outcomes of live-donor liver transplantation (LDLT) in pediatric patients.
- To compare LDLT with deceased-donor liver transplantation (DDLT) in a setting with limited deceased donor availability.
Main Methods:
- Retrospective analysis of prospectively collected data from 78 pediatric patients (73 days to 17 years) who underwent 83 liver transplants between 1993 and 2008.
- Categorization of transplants into living-related liver transplantations (LRLTs) (n=62) and deceased-donor liver transplantations (DDLTs) (n=21).
- Mean follow-up period of 6.5 years.
Main Results:
- Overall 1-, 2-, and 5-year patient survival rates were 91%, 90%, and 88%, respectively.
- Graft survival rates at 1, 2, and 5 years were 87%, 86%, and 83%, respectively.
- Comparable survival rates were observed between LRLT and DDLT groups (P = .58) and between younger (<12 months) and older pediatric patients (P = .65).
Conclusions:
- Meticulous surgical techniques and postoperative care enable successful live-donor liver transplantation for pediatric patients.
- LDLT is a justifiable and effective option to save lives in pediatric populations with scarce deceased donor organs.
- Live donors experienced minimal complications, with all returning to normal activities.
Aim:
The study aimed to assess the outcome of live-donor liver transplantation for pediatric patients in a region with limited access to deceased donors.
Patients And Methods:
From September 1993 to September 2008, 78 pediatric patients aged between 73 days and 17 years (mean, 40 months) received 83 liver transplants. Sixty-two were living-related liver transplantations (LRLTs), and 21 were deceased-donor liver transplantations (DDLTs). The mean follow-up period was 6.5 years. The prospectively collected data of these patients were analyzed retrospectively.
Results:
The 1-, 2-, and 5-year survival rates of patients and grafts were 91%, 90%, 88% and 87%, 86%, 83%, respectively. The survival rates of LRLT patients and DDLT patients were 89%, 89%, 87%, and 90%, 86%, 86%, respectively (P = .58). The survival rates of patients aged 12 months or younger and patients older than 12 months were 95%, 92%, 90% and 90%, 90%, 87%, respectively (P = .65). One live donor developed temporary peroneal palsy, and another developed lung collapse (3%, 2/62). All live donors resumed their normal activities with no difficulty.
Conclusion:
With meticulous surgical techniques and postoperative care, it is justifiable to accept donated livers from voluntary live donors for transplantation to save pediatric patients in a place with scarce deceased donors.
