Ciria R, Sánchez-Hidalgo J M, Briceño J, Naranjo A, Pleguezuelo M, Díaz-Nieto R, Luque A, Jiménez J, García-Menor E, Gilbert J J, de la Mata M, Pérez-Navero J L, Solórzano G, Rufián S, Pera C, López-Cillero P
Unit of Hepatobiliary Surgery and Liver Transplantation, Reina Sofía University Hospital, Cordoba, Spain.
Transplant Proc. 2009 Jul-Aug;41(6):2444-6. doi: 10.1016/j.transproceed.2009.06.072.
To analyze the primary factors that influence the development and consolidation of a pediatric liver transplantation program.
This was a retrospective study of 100 liver transplantation procedures performed in 84 pediatric patients between May 1990 and November 2007. The male-female ratio was 40:60. Mean (SD) age was 5 years (40 patients were younger than 2 years); cold ischemia time was 7.10 (3.1) hours; surgery time was 5.2 (2.2) hours; and time on the waiting list for transplantation was 75 (range, 1-1012) days. Indications for transplantation included cholestatic disease (43%), acute hepatic failure (AHF; 34%), metabolic disorders (14%), and cirrhosis (9%). Transplanted organs included 3 split grafts, 29 partial grafts, and 8 living-donor grafts.
Mean graft survival was 70.4%, 59.2%, and 58.1% at 1, 3, and 5 years, respectively. Factors that influenced graft outcome were age younger than 2 years; surgery time more than 6 hours; and AHF vs cholestatic disease, metabolic disorders, and cirrhosis. There were no significant differences in long-term (51% vs 59%) and short-term (71% vs 70%) graft survival between procedures performed in 1990-1998 compared with those performed in 1999-2007; however, there was a higher percentage (P = .005) of recipients at high risk (age younger than 2 years or with AHF) in the later period. All data were consistent with those of the European Liver Transplant Registry 2007.
A pediatric liver transplantation program can be established by a group experienced in liver transplantation.
