Related Experiment Video
Updated: Jul 11, 2025
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
Outcome of pediatric living donor liver transplant: Experience from Pakistan; a resource limited setting
Sahira Aaraj1, Sabeen Abid Khan2, Fatima Maroof2
1Shifa Tameer e Millat University/Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan.
Insights
Pediatric living donor liver transplantation (LDLT) in Pakistan offers significant survival benefits for children with liver disease. Post-transplant care, including nutritional support and complication management, is crucial for improving long-term outcomes.
Area of Science:
- Hepatology
- Pediatric Surgery
- Transplantation Medicine
Background:
- Liver transplantation (LT) is a life-saving treatment for pediatric liver diseases.
- Pediatric LT is established in Western countries but novel in resource-limited settings like Pakistan.
Purpose of the Study:
- To evaluate the outcomes and survival rates of pediatric liver transplant recipients.
- To highlight the findings from Pakistan's first pediatric liver transplant center.
Main Methods:
- Retrospective analysis of pediatric LT cases from 2012 to 2019.
- Data collected from the Hepatobiliary and liver transplant department at Shifa International Hospital, Islamabad.
- Analysis included indications, survival, and complications of pediatric LT.
Main Results:
- Forty-five pediatric patients (under 18) underwent living donor liver transplantation (LDLT).
- Common indications were cryptogenic liver disease and Wilson disease; 75% had chronic liver disease, 24% acute liver failure.
- 30-day, 1-year, 3-year, and 5-year survival rates were 77.8%, 75.6%, 73.3%, and 60.6%, respectively. Mortality was highest in biliary atresia cases.
Conclusions:
- Pediatric LDLT provides disease-free survival for pediatric patients.
- Improved survival is achievable through nutritional rehabilitation and proactive management of post-operative complications.
Introduction:
Liver transplantation (LT) has emerged as a lifesaving modality for many liver diseases in children. Pediatric LT is an established treatment in the Western world but is relatively a new procedure in resource-limited countries like Pakistan. The study aims to highlight the outcomes and survival of pediatric recipients from the first pediatric liver transplant center in Pakistan.
Method:
A retrospective analysis of pediatric LT was done from 2012 to 2019. The study was conducted in the Hepatobiliary and liver transplant department of Shifa International Hospital (SIH), Islamabad. A detailed analysis for indications for pediatric LT, survival, and complications was done.
Results:
Forty-five patients under 18 years of age underwent Living donor liver transplant (LDLT) in SIH. Median age was 9 years and M:F of 2:1. Cryptogenic liver disease followed by Wilson disease were the two most common indications of LT. The majority of patients had chronic liver disease 34 (75%) while 11 (24%) had acute liver failure. The right lobe graft was the most common type of graft 19 (42.2%). Thirty days, 1-year, 3-year, and 5-year survival was 77.8%, 75.6%, 73.3%, and 60.6% respectively. Mortality was highest in patients with biliary atresia 4 (33%). Causes of death included pulmonary embolism, sepsis, surgical complications, and acute kidney injury. Mean survival was 88.850 months (±7.899) (CI 73.369-104.331).
Conclusion:
Pediatric LDLT has offered disease-free survival for patients. Survival can improve further with nutritional rehabilitation and anticipation and management of post-operative complications.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure