Present State and Future Prospects of Pediatric Liver Transplantations

Regarding liver transplantations in Japan, with no progress having been made in deceased donor liver transplantations, a living donor liver transplantation performed on a boy with end-stage liver cirrhosis caused by biliary atresia by Nagasue et al. at Shimane University in November 1989 was the first case of its kind. Unlike deceased donor liver transplantations, living donor liver transplantations have two major advantages. First, because organs are donated from healthy adults, it is possible to transplant organs with better viability compared to deceased donor organs, which have been preserved in cold storage for a long time. Second, depending on the recipient's condition, it is possible to conduct elective surgery at the optimal time. In Japan, the number of annual liver transplantation cases is approximately 400, with the number of annual pediatric liver transplantation cases stable at approximately 120 cases. The patient survival rate of pediatric liver transplantation cases is relatively good at 89.4% over the course of 1 year, 86.8% over 5 years, 84.4% over 10 years, and 80.9% over 20 years. The liver transplantation program was initiated at the National Center for Child Health and Development, Tokyo, Japan, in November 2005, providing liver transplantation treatment to 510 pediatric patients with end-stage liver disease to date. This article outlines the history of liver transplantations in Japan along with the present state of liver transplantations at the National Center for Child Health and Development.