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Pediatric liver transplantation: A report from a pediatric surgical unit
Sanjay Rao1, Ashley L J D'Cruz, Rajiv Aggarwal
1Department of Pediatric Surgery, Narayana Hrudayalaya Hospitals, Bangalore, India.
Insights
Pediatric liver transplantation in India is feasible, with a 71% overall survival rate. Recent cases show improved outcomes (92% survival), demonstrating the program
Area of Science:
- Pediatric surgery
- Hepatology
- Transplant medicine
Background:
- Liver transplantation is a proven treatment for pediatric end-stage liver disease globally.
- Adoption in India has lagged due to cost, infection risks, long-term care challenges, and expertise limitations.
Purpose of the Study:
- To document the experience and outcomes of pediatric liver transplantation in India.
- To assess the feasibility of establishing a sustainable pediatric liver transplant program.
Main Methods:
- Retrospective analysis of 28 pediatric liver transplant cases.
- Utilized living donor transplants, predominantly from mothers.
- Documented surgical and medical complications.
Main Results:
- Biliary atresia (15 cases) and metabolic liver disease were primary indications.
- Surgical complications included bile leaks (3) and vascular issues (6).
- Medical issues comprised infections, acute rejection, and renal failure. Overall survival was 71%, improving to 92% in the last 14 cases.
Conclusions:
- Successful pediatric liver transplantation is achievable in India.
- The program demonstrates significant improvement and long-term positive outcomes for surviving children.
Background:
Liver transplantation is well established worldwide as an effective treatment for end-stage liver disease in children. Acceptance in India has been slow because of considerations of cost, infections, inability to support long-term care, and non-availability of expertise.
Aim:
This study was designed to report our experience with pediatric liver transplantation.
Materials And Methods:
Twenty-eight children underwent liver transplantation.
Results:
Biliary atresia was the commonest indication (n = 15) followed by metabolic liver disease. Twenty-six children had living donor transplants, mothers being the donors in a majority of these. Common surgical complications included bile leaks (n = 3) and vascular problems (n = 6). Common medical complications included infections, acute rejection, and renal failure. Overall, patient survival was 71%, while that for the last 14 cases was 92%. All survivors are doing well, have caught up with physical and developmental milestones and are engaged in age appropriate activities.
Conclusions:
The study demonstrates the feasibility of a successful pediatric liver transplant program in our country.
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