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Orthotopic liver transplantation for children with Alagille syndrome
Ronen Arnon1, Rachel Annunziato, Tamir Miloh
1Pediatrics, Mount Sinai Medical Center, New York, NY 10029, USA. Ronen.Arnon@mountsinai.org
Unlabelled:
AGS is an inherited disorder involving the liver, heart, eyes, face, and skeleton.
Aim:
To determine the outcome of LT in children with AGS compared to those with BA.
Methods:
Children with AGS and BA who had a LT between 10/1987 and 5/2008 were identified from the UNOS database.
Results:
Of 11 467 children who received a liver transplant, 461 (4.0%) had AGS and 3056 (26.7%) had BA. One- and five-yr patient survival was significantly lower in patients with AGS in comparison with patients with BA (AGS; 82.9%, 78.4%, BA; 89.9%, 84%, respectively). Early death (<30 days from transplant) was significantly higher in AGS than in BA. One- and five-yr graft survival was significantly lower in AGS than in BA (AGS; 74.7%, 61.5%, BA; 81.6%, 70.0%, respectively). Death from graft failure, neurological, and cardiac complications was significantly higher in patients with AGS than in patients with BA. Serum creatinine at transplant, prior LT, and cold ischemic time >12 h were identified as risk factors for death.
Conclusion:
Children with AGS were older at the time of LT and their one- and five-yr patient and graft survival were significantly lower compared to BA. Risk factors for poor outcome in AGS after LT were identified.
