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Outcomes of Liver Transplantation in Infants: A Retrospective Cohort Study
Halil Erbis1, Eyyup Mehmet Kilinc2, Aynur Camkiran Firat3
1Department of General Surgery and Transplantation, Biruni University Hospital, Istanbul, Turkey.
Insights
Liver transplantation (LT) in infants under 12 months is feasible with acceptable outcomes. This study found no significant impact of demographic or etiological factors on survival rates.
Area of Science:
- Pediatric Surgery
- Hepatology
- Transplant Immunology
Background:
- Liver transplantation (LT) is vital for infants with end-stage liver disease.
- Limited data exists on LT outcomes specifically for infants under 12 months old.
- Understanding factors influencing infant LT survival is crucial.
Purpose of the Study:
- To evaluate the clinical course and outcomes of LT in infants under 12 months.
- To assess the impact of demographic and etiological factors on infant LT mortality and survival.
Main Methods:
- Retrospective analysis of 64 infants (< 12 months) undergoing LT (Jan 2019 - Mar 2024).
- Collected demographic, clinical, laboratory, and LT-specific data.
- Analyzed postoperative complications and survival using Kaplan-Meier and log rank tests.
Main Results:
- Biliary atresia was the most common indication (85.9%); median PELD score was 15.5.
- Overall mortality was 17.2% (30-day: 6.3%, late: 10.9%); 1-year survival was 32.8%.
- No significant impact of sex, age, diagnosis, graft type, or complications on overall survival (P > .05).
Conclusions:
- LT in infants is achievable with manageable morbidity and mortality.
- Increased surgical experience and standardized protocols can improve outcomes.
- Further research may refine strategies for infant liver transplantation.
Background:
Liver transplantation (LT) is a crucial treatment for infants with end-stage liver disease, yet specific data on LT outcomes in infants under 12 months old remain limited. This study aims to present the clinical course and outcomes of infants who underwent LT, assessing the impact of demographic and etiological differences on mortality and survival.
Methods:
A retrospective analysis was conducted on 64 infants (< 12 months) who underwent LT between January 2019 and March 2024. Demographic, clinical, and laboratory data were collected from their medical records. LT-specific details, postoperative complications, and survival data were analyzed.
Results:
The median age of the infants was 157 days, with 37 boys (57.8%) and 27 girls (42.2%). Biliary atresia was the most common diagnosis (85.9%), and seven infants had undergone a previous Kasai procedure. The median pediatric end-stage liver disease (PELD) score was 15.5. Left lateral segmentectomy was the predominant graft type (60.9%). The median pediatric intensive care unit (PICU) and hospital stays were 5 and 21 days, respectively. Complications occurred in 20 infants (31.3%), with vascular and biliary complication rates both at 12.5%. The overall mortality rate was 17.2%, with early (30-day) and late mortality rates of 6.3% and 10.9%, respectively. The median overall survival (OS) was 204.5 days, and the 1-year survival rate was 32.8%. Kaplan-Meier and log rank analyses showed no significant impact of sex, age, diagnostic groups, graft type, or surgical complications on OS (P > .05).
Conclusions:
LT in infants can be performed with acceptable morbidity and mortality rates, particularly with increased experience and standardized protocols.
