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Updated: May 8, 2026
Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
Improved outcomes in liver transplantation in children with acute liver failure
Seak Hee Oh1, Kyung Mo Kim, Dae Yeon Kim
1*Department of Pediatrics †Department of Pediatric Surgery ‡Department of Pediatric Radiology §Department of Radiology ||Department of Anesthesiology ¶Department of Pathology #Division of Hepato-Biliary Surgery and Liver Transplantation **Department of Surgery, Division of Hepato-Biliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Insights
This study reviewed living donor liver transplants for pediatric acute liver failure (ALF), showing good graft and patient survival rates. Pretransplant thrombocytopenia and use of the molecular adsorbent recycling system were linked to graft loss.
Area of Science:
- Pediatric Hepatology
- Organ Transplantation
- Acute Liver Failure
Background:
- Acute liver failure (ALF) in children presents significant management challenges.
- Living donor liver transplantation (LDLT) is a crucial option for pediatric ALF when cadaveric organs are scarce.
Purpose of the Study:
- To evaluate the outcomes of a pediatric liver transplant program dominated by living donors.
- To identify factors influencing graft survival and patient prognosis in pediatric ALF.
Main Methods:
- Retrospective chart review of 50 children with ALF at a major Korean liver center.
- Analysis of primary living donor liver transplantations (n=47) versus cadaveric liver transplantations (n=3).
Main Results:
- Graft survival rates at 1 and 5 years were 81.9% and 79.2%, respectively.
- Overall patient survival rates at 1 and 5 years were 87.9%.
- Pretransplant thrombocytopenia and preoperative use of the molecular adsorbent recycling system were associated with graft loss.
Conclusions:
- A living donor-dominant liver transplant program can achieve acceptable clinical outcomes for pediatric ALF.
- Further research is needed to clarify the role of pretransplant thrombocytopenia in post-transplant prognosis.
Objective:
The aim of our study was to review the experiences of a living donor-dominant transplantation program for children with acute liver failure (ALF).
Methods:
Data were derived from the retrospective chart review of 50 children with ALF in a major liver center in the Republic of Korea.
Results:
A total of 50 children with ALF underwent 47 (94%) primary living donor liver transplantations and 3 (6%) cadaveric liver transplantations. The cumulative survival rates of the grafts at 1 and 5 years were 81.9% and 79.2%, respectively. The overall retransplantation rate was 12%. The cumulative survival rates of these patients at 1 and 5 years were all 87.9%. Most incidents of mortality followed the failure of the preceding graft. We observed no mortalities among donors. Based on multivariate analysis, children who had pretransplant thrombocytopenia or had to use the molecular adsorbent recycling system preoperatively were related to the graft loss. Age younger than 2 years and a hyperacute onset (within 7 days) of hepatic encephalopathy were associated with pretransplant thrombocytopenia.
Conclusions:
Living donor-dominant transplantation program in the present study demonstrates tolerable achievements in terms of clinical outcomes of recipients and donors; however, putative factors, such as pretransplant thrombocytopenia, seem to play unclear roles in a poor prognosis following transplantation.
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