Experience with partial liver transplantation in Hannover.

Area of Science:

• Hepatology
• Transplantation Surgery
• Pediatric Surgery

Background:

• Liver transplantation is a critical treatment for end-stage liver disease in both children and adults.
• The use of split liver grafts and adult donors for pediatric recipients presents unique challenges and opportunities.

Purpose of the Study:

• To evaluate patient and graft survival rates in pediatric liver transplantation (PLTx).
• To compare outcomes between elective and urgent PLTx procedures.
• To analyze causes of graft loss and postoperative complications in PLTx.

Main Methods:

• Retrospective analysis of 37 pediatric liver transplantations performed over a 7-year period in 32 patients.
• Inclusion of various graft types: left lateral liver (LLL), left liver (LL), and whole right liver (RL).
• Assessment of donor-to-recipient body weight ratios and use of split and adult-donor grafts in pediatric recipients.

Main Results:

• Two-year patient and graft survival rates for elective PLTx were 69.7% and 50.5%, not significantly different from urgent cases.
• Overall 30-day mortality was 18.8%, primarily linked to the patients' pre-transplant clinical status.
• Graft loss occurred in 29.7% of cases, mainly due to chronic rejection and primary nonfunction.

Conclusions:

• Pediatric liver transplantation demonstrates acceptable survival outcomes, with no significant difference between elective and urgent procedures.
• Graft loss is predominantly associated with liver-specific complications, highlighting the need for strategies to mitigate rejection and nonfunction.
• Postoperative surgical complications were comparable to whole liver transplantation, suggesting the safety of current PLTx techniques.