[Living donor graft versus cadaveric in pediatric liver transplantation. Multicentric study]

Liver transplantation (LT) is the therapy of choice in patients with end-stage chronic liver disease, se vere acute liver failure, and metabolic diseases, among other pathologies. Historically, more patients have been on the waiting list than organs for transplantation. In 1999, we started a living-related donor liver transplantation program.

to compare surgical results and graft survival in liver transplanted patients with living donor graft (LDG) versus deceased donor graft (DDG).

Retrospective observational analytical study of pediatric patients undergoing LT at the Dr. Luis Calvo Mackenna Hospital and Las Condes Clinic between 1999 and 2020 in Santia go, Chile. They were grouped into LDG and DDG and demographic characteristics, complications, and graft and patient survival were compared.

276 LT were performed. Of these, 198 were included, of which 81 were LDG and 117 were DDG. The recipients of LDG had a lower average weight (p < 0.001), a higher frequency of portal vein thrombosis (13.6% versus 4.3%; p = 0.006), biliary stricture (38.3% versus 14.5%; p < 0.001), and surgical reintervention (76.5% versus 57.3%, p = 0.006). Survival of DDG and LDG patients at 1 year and 5 years was 86.1% and 72.3% versus 82.5% and 81.1%, respectively (p = 0.16). Graft survival at one year and 5 years was significantly higher in LDG with 80% and 78.6% versus 79% and 62% in DDG, respectively (p = 0.032). The recipient's weight between 9-13 kg was significantly correlated with a higher frequency of hepatic artery thrombosis (RR = 1.98) in the multivariate analysis.

Our study demonstrated comparable long-term results in LDG despite greater postoperative complications, which supports continuing its use as an option in pediatric LT.