Related Experiment Video
Updated: Aug 1, 2025
Author Spotlight: Evaluating Therapeutic Strategies to Enhance Liver Regeneration
Published on: May 24, 2024
The Factors Affecting Mortality After Pediatric Liver Transplantation and Long-Term Survival Outcomes: A Single
Ali Avanaz1, Demet Sarıdemir Ünal1, Abdullah Kisaoglu1
1Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Insights
Pediatric liver transplantation (PLT) shows good long-term survival rates comparable to national data. However, reducing vascular complications like hepatic artery thrombosis is key to improving outcomes in pediatric liver recipients.
Area of Science:
- Pediatric Hepatology
- Transplant Surgery
- Gastroenterology
Background:
- Liver transplantation (LT) is a vital treatment for pediatric liver diseases such as biliary atresia and hepatoblastoma.
- Published 5-year survival rates for pediatric liver transplantation (PLT) range from 85.4% to 93.5%.
Purpose of the Study:
- To evaluate the single-center experience with pediatric liver transplantation (PLT).
- To analyze long-term outcomes and compare them with existing literature.
- To identify predictors of patient survival in PLT.
Main Methods:
- Retrospective analysis of 40 patients under 18 who underwent LT between June 2015 and June 2021.
- Evaluation of recipient demographics, liver disease etiology, follow-up duration, and postoperative complications (vascular and biliary).
- Assessment of donor characteristics.
Main Results:
- The study included 20 boys and 20 girls, with a median age of 42 months.
- Biliary disorders were the most common indication for LT (45%).
- Survival rates at 1, 3, 5, and 7 years were 85%, 82.1%, 82.1%, and 82.1%, respectively. Pediatric end-stage liver disease score, hepatic artery thrombosis, and portal vein thrombosis were associated with mortality.
Conclusions:
- The center's long-term survival rates for PLT are comparable to national benchmarks.
- Reducing vascular complications is crucial for enhancing PLT outcomes.
- Further research into mitigating vascular complications could lead to superior results in pediatric liver transplantation.
Background:
Liver transplantation (LT) is a treatment modality in the pediatric population for several diseases like biliary atresia, metabolic liver disease, hepatoblastoma, and so on. According to the Organ Procurement and Transplantation Network, 5-year survival was reported as 85.4% to 93.5% by age after pediatric liver transplantation (PLT). This study aimed to evaluate our single-center experience of PLT by analyzing long-term results, comparing the outcomes with the literature, and identifying predictors of patient survival.
Methods:
The data of 40 patients who underwent LT at <18 years of age between June 2015 and June 2021 were studied retrospectively. Recipient characteristics such as age, sex, etiology of liver disease follow-up time, postoperative vascular and biliary complications, and donor characteristics were evaluated.
Results:
There were 20 (50%) girls and 20 (50%) boys, and the median age was 42 (IQR = 9-117) months. The most common indications of LT were biliary disorders (45%). A whole liver graft was used in 7 (17%), a right lobe graft in 9 (23%), a left lobe graft in 4 (10%), and a left lateral lobe graft in 20 (50%) of the recipients. The 1-, 3-, 5-, and 7-year survival rates were 85%, 82.1%, 82.1%, and 82.1%, respectively. The multivariate survival analysis revealed that the pediatric end-stage liver disease score, hepatic artery thrombosis, and portal vein thrombosis are associated with overall mortality.
Conclusion:
In conclusion, our long-term survival is similar to the literature, with satisfactory results. However, reducing the vascular complication rates can provide superior results on PLT.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:16Kidney Transplant III: Nursing Management
01:26Kidney Transplant II: Surgical Procedure