Transplanting Livers in Young Children - Looking Back at 100 Cases

Area of Science:

• Pediatric Hepatology
• Transplant Surgery
• Public Health in Emerging Economies

Background:

• End-stage liver disease (ESLD) in children necessitates liver transplantation (LT) as the definitive treatment.
• Acceptance of LT in India is hindered by financial and logistical barriers, not a lack of expertise.
• This report details the experience of a single center in India performing pediatric LT.

Purpose of the Study:

• To review the outcomes of 100 pediatric liver transplantation (LT) cases at a single center in India.
• To highlight the challenges and successes of LT in an emerging economy.
• To assess the long-term feasibility and complications of pediatric LT.

Main Methods:

• Prospective analysis of all pediatric LT cases performed since 2005.
• Data collected from a structured institutional database.
• Review of patient demographics, indications, procedures, complications, and outcomes.

Main Results:

• 100 pediatric LTs were performed, with biliary atresia as the most common indication (57%).
• Live donor LT was predominant (91%), with mothers as the primary donors.
• Overall survival was 70% at a mean follow-up of 8.5 years, with common long-term sequelae including infections and graft rejection.

Conclusions:

• Pediatric liver transplantation (LT) is feasible in India, demonstrating significant survival rates.
• Long-term management requires addressing patient compliance, financial constraints, infections, and neurological issues.
• Close monitoring and regular follow-up are essential for early detection and treatment of late-onset complications to improve long-term outcomes.