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Our Pediatric Liver and Kidney Transplant Activities in 2021
Emre Karakaya1, Aydıncan Akdur, Ebru Hatice Ayvazoğlu Soy
1From the Baskent University, Department of General Surgery, Division of Transplantation, Ankara, Turkey.
Insights
Pediatric liver and kidney transplants in 2021 showed successful outcomes, with living related donors being common. While most kidney transplant recipients were discharged successfully, two pediatric liver transplant recipients died from sepsis.
Area of Science:
- Pediatric solid-organ transplantation
- Nephrology
- Hepatology
Background:
- Liver and kidney transplants are crucial for children with end-stage organ failure.
- Pediatric solid-organ transplantation requires specialized centers due to surgical complexities.
- This study reviews transplants performed at our center in 2021.
Purpose of the Study:
- To assess the outcomes of pediatric liver and kidney transplants performed in 2021.
- To evaluate the safety and efficacy of solid-organ transplantation in young children.
- To highlight the importance of experienced multidisciplinary teams in pediatric transplant care.
Main Methods:
- Retrospective analysis of liver and kidney transplants performed between January 1, 2021, and December 31, 2021.
- Data collected included recipient demographics, comorbidities, transplant etiology, donor type, and clinical outcomes.
- Analysis focused on pediatric recipients (under 18 years).
Main Results:
- In 2021, 19 pediatric liver transplants and 12 pediatric kidney transplants were performed.
- Pediatric liver recipients (mean age 3.4 years) primarily had biliary atresia; most grafts were from living related donors. Two recipients died post-transplant.
- Pediatric kidney recipients (mean age 14.1 years) commonly had vesicoureteral reflux; all grafts were from living related donors, and all recipients were discharged successfully.
Conclusions:
- Pediatric solid-organ transplantation, though complex, can achieve successful outcomes at experienced centers.
- Living related donation plays a significant role in pediatric liver and kidney transplantation.
- Careful patient selection and experienced surgical teams are vital for minimizing complications in pediatric transplant recipients.
Objectives:
In children with end-stage renal disease, chronic liver failure, or acute liver failure, liver transplant and kidney transplant are the most effective modalities for better clinical outcomes compared with other therapies. However, children are particularly susceptible to surgical complications, so pediatric solid-organ transplants should be reserved for centers with substantial experience and multidisciplinary expertise. Here, we assessed liver and kidney transplants performed at our center in 2021.
Materials And Methods:
From November 3, 1975, to December 31, 2021, we performed 701 liver transplants and 3290 kidney transplants. From January 1, 2021, to December 31, 2021, we performed 21 liver transplants (19 in children) and 114 kidney transplants (12 in children). We recorded age, sex, body mass index, comorbidities, etiologies, laboratory values, and clinical outcomes.
Results:
For the year 2021, we performed 19 pediatric liver transplants and 12 pediatric kidney transplants. Mean age of liver recipients was 3.4 years, and 8 were male patients. The most common etiology was biliary atresia (n = 7). All liver grafts were from living related donors who were first-degree (n = 16) or second- degree (n = 3) relatives of the recipients. Mean hospital stay was 17.6 days. All but 2 liver transplant recipients were discharged successfully (2 died from sepsis in the early postoperative period). Mean age of kidney transplant recipients was 14.1 years, and 4 were male patients. The most common etiology was vesicoureteral reflux (n = 3). One kidney graft was from a deceased donor, with the rest from living related donors who were first-degree relatives of the recipients (n = 11; mother for 8 recipients and father for 3 recipients). Mean hospital stay was 4.3 days. All kidney transplant recipients were discharged successfully.
Conclusions:
Solid-organ transplants for young children are often complex but can be performed successfully at experienced transplant centers.
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