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Results of pediatric liver transplant: a single-center experience
Gökhan Moray1, Tugan Tezcaner, Aydıncan Akdur
1From the Department of General Surgery, Baskent University, School of Medicine, Ankara, Turkey.
Insights
Pediatric liver transplants show promising outcomes, with high survival rates and effective management of complications. This study highlights the success of liver transplantation in children with end-stage liver disease.
Area of Science:
- Pediatric Surgery
- Hepatology
- Transplantation Medicine
Background:
- Liver transplantation is a curative option for pediatric end-stage liver disease and acute liver failure.
- Evaluating outcomes, complications, and long-term results is crucial for improving pediatric liver transplant protocols.
Purpose of the Study:
- To assess the outcomes, complications, and long-term follow-up results of pediatric liver transplants.
- To analyze demographic features, graft sources, and perioperative/postoperative outcomes.
Main Methods:
- Retrospective evaluation of 188 pediatric liver transplant patients between 2001 and 2013.
- Analysis of demographic data, graft sources, perioperative and postoperative complications, and revision transplants.
- Assessment of treatment outcomes for complications and graft survival rates.
Main Results:
- Most grafts (90.9%) were from living-related donors.
- Postoperative hemorrhage (6.9%), biliary leakage (17.5%), and biliary stricture (17%) were key complications.
- Revision transplants were needed in 5.8% of cases, primarily due to rejection (50%).
- Overall 5- and 10-year survival rates were 82.3% and 78.9%, respectively.
Conclusions:
- Pediatric liver transplantation at this center demonstrates very promising outcomes.
- Effective management of complications and revision transplants contributes to good graft function and survival.
- Continued advancements in care and collaborative efforts are expected to increase the number of successful pediatric transplants.
Objectives:
Liver transplant is an established curative therapy for children with chronic end-stage liver disease or acute liver failure. In this study, we aimed to evaluate pediatric liver transplant in terms of outcomes, complications, and long-term followup results.
Materials And Methods:
Pediatric patients who had liver transplant in our institution were included. We retrospectively evaluated demographic features including body weight, Child-Pugh score, etiology of liver disease, graft source, perioperative outcomes, perioperative complications, postoperative complications, and long-term results. Outcomes of treatment of complications and revision transplant were evaluated.
Results:
Between September 2001 and December 2013, there were 188 pediatric liver transplants performed in our institution. Most grafts (90.9%) were obtained from living-related donors. There were 13 patients (6.9%) who had an intervention because of a hemorrhage postoperatively. Biliary leakage was observed in 33 patients (17.5%) and biliary stricture during follow-up was observed in 32 patients (17%). Thrombosis rates in the hepatic artery and portal vein were 12.3% and 0.5%. Revision transplant was performed in 11 patients (5.8%); reason for revision transplant was rejection in 50% patients. The remaining children were alive with good graft functioning after treatment of complications and revision transplant. The overall 5- and 10-year survival rates were 82.3% and 78.9%.
Conclusions:
The overall outcomes of pediatric liver transplant at our center are very promising. With improved care of younger children and the combined efforts of the parents and medical team, the number of the children receiving transplants will increase in the future.
