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Published on: November 7, 2020
Long term outcomes of pediatric liver transplantation according to age
Jeik Byun1, Nam-Joon Yi1, Jeong-Moo Lee1
1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Insights
Pediatric liver transplantation (LT) outcomes are excellent for infants and older children. This study found that LT in infancy is not riskier than in older children, with similar survival rates.
Area of Science:
- Pediatric surgery
- Hepatology
- Transplantation medicine
Background:
- Liver transplantation (LT) is crucial for end-stage liver disease.
- LT in infants remains understudied.
- Infants often present with higher disease severity (higher Pediatric End-stage Liver Disease scores).
Purpose of the Study:
- To compare outcomes of LT in infants versus older children.
- To analyze patient survival rates and post-transplant complications.
- To evaluate the safety and efficacy of LT in infancy.
Main Methods:
- Retrospective analysis of 152 pediatric LT cases from 1992-2010.
- Patients divided into two groups: <12 months (Group A) and >12 months (Group B).
- Comparison of survival rates and post-LT complications between groups.
Main Results:
- Infants (Group A) had higher PELD scores and lower incidence of fulminant hepatitis.
- Higher rates of post-transplant lymphoproliferative disorder and portal vein complications in infants.
- Excellent 1, 5, and 10-year survival rates for both groups (93% for Group A, 88-92% for Group B).
Conclusions:
- Pediatric LT demonstrates excellent survival outcomes.
- LT in infancy is comparable in risk to LT in older children.
- Age is not a significant factor in determining LT success in children.
Abstract:
Liver transplantation (LT) has been the key therapy for end stage liver diseases. However, LT in infancy is still understudied. From 1992 to 2010, 152 children had undergone LT in Seoul National University Hospital. Operations were performed on 43 patients aged less than 12 months (Group A) and 109 patients aged over 12 months (Group B). The mean age of the recipients was 7 months in Group A and 74 months in Group B. The patients' survival rates and post-LT complications were analyzed. The mean Pediatric End-stage Liver Disease score was higher in Group A (21.8) than in Group B (13.4) (P = 0.049). Fulminant hepatitis was less common in Group A (4.8%) than in Group B (13.8%) (P = 0.021). The post-transplant lymphoproliferative disorder and portal vein complication were more common in Group A (14.0%, 18.6%) than in Group B (1.8%, 3.7%) (P = 0.005). However, the 1, 5, and 10 yr patient survival rates were 93%, 93%, and 93%, in Group A and 92%, 90%, and 88% in Group B (P = 0.212). The survival outcome of pediatric LT is excellent and similar regardless of age. LTs in infancy are not riskier than those of children.
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