Haberal Mehmet, Sevmis Sinasi, Karakayali Hamdi, Ozcay Figen, Moray Gokhan, Yilmaz Ugur, Torgay Adnan, Demirhan Beyhan, Arslan Gulnaz
Department of General Surgery and Transplantation, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2008 Mar;6(1):7-13.
Liver transplant in the pediatric population has become an accepted treatment modality for children with end-stage liver disease. In this study, we analyze our experiences with pediatric liver transplant at our center.
Since September 2001, 8 deceased-donor and 96 living-donor liver transplants have been done in 101 children (mean age, 6.7 +/- 5.5 years; range, 2 months to 17 years). The children's charts were reviewed retrospectively.
Indications for liver transplant were cholestatic liver disease (n=17), biliary atresia (n=24), Wilson's disease (n=16), fulminant liver failure (n=18), hepatic tumor (n=13), and other (n=13). The median pediatric end-stage liver disease score was 23.1 +/- 11.1 (range, -8 to 48). The median follow-up was 24.2 +/- 19.4 months (range, 1-77 months). Three children underwent retransplant. The main complications were infections (25.9%) and surgical complications (39.5%) (including biliary complications and vascular problems). The incidence of acute cellular rejection was 42.3%. Sixteen children died during follow-up, and, at the time of this writing, the remaining 85 children (85%) were alive with good graft functioning, showing patient survival rates of 90%, 85%, and 83% at 6, 12, and 36 months, respectively.
In conclusion, the overall outcomes of pediatric liver transplantation at our center are quite promising.
肝移植在儿科人群中已成为终末期肝病患儿可接受的治疗方式。在本研究中，我们分析了本中心小儿肝移植的经验。
自2001年9月以来，已对101名儿童（平均年龄6.7±5.5岁；范围2个月至17岁）进行了8例尸体供肝肝移植和96例活体供肝肝移植。对患儿病历进行回顾性分析。
肝移植的适应证包括胆汁淤积性肝病（n = 17）、胆道闭锁（n = 24）、威尔逊病（n = 16）、暴发性肝衰竭（n = 18）、肝肿瘤（n = 13）及其他（n = 13）。小儿终末期肝病评分中位数为23.1±11.1（范围-8至48）。中位随访时间为24.2±19.4个月（范围1至77个月）。3名儿童接受了再次移植。主要并发症为感染（25.9%）和手术并发症（39.5%）（包括胆道并发症和血管问题）。急性细胞排斥反应发生率为42.3%。16名儿童在随访期间死亡，在撰写本文时，其余85名儿童（85%）存活且移植肝功能良好，6个月、12个月和36个月时的患者生存率分别为90%、85%和83%。
总之，本中心小儿肝移植的总体结果很有前景。
