Guo Chun-Bao, Pu Cong-Lun, Li Ying-Cun, Zhang Ming-Man, Deng Yuhua, Yan Lv-Nan, Kang Quan, Jin Xian-Qing
Hepatogastroenterology. 2014 Mar-Apr;61(130):391-7.
BACKGROUND/AIMS: In the last 10 years, the early patient outcome of liver transplantation in children have significantly improved. Now the overall outcomes of pediatric LT are promising.
In this study, we review the outcome of all pediatric liver transplants performed at our center and analyze our experiences with pediatric liver transplant. Of the 34 liver transplant recipients, 26 were highly urgent (19.7%).
Actuarial patient survival rates at 6, 12, and 36 months was 82.9%, 79.8% and 72.2%, respectively. Indications for liver transplant were biliary atresia (n = 22), Wilson's disease (n = 4), glycogen storage disease (n = 3), portal vein cavernous transformation (PVCT) (n = 3), fulminant liver failure (n = 1), and cryptogenic cirrhosis (n = 1). The main complications were surgical complications (including biliary complications, portal vein or arterial complications, intestinal perforation, postoperative bleeding, of which 20% required reoperation) and infections. Cyclosporine was the primary immunosuppressive agent used in 70.6% of patients, with a 26.5% incidence of acute allograft rejection within the first six months. One children underwent re-transplant as a result of hepatic artery thrombosis. Nine children died during followup. They were related to portal vein thrombosis (one), chronic rejection (one), sepsis (one), post-transplant lymphoproliferative disease (one) and so on.
The overall outcomes of pediatric liver transplantation at our center are promising. Advances in post-transplant care and monitoring of the recipients, technical refinements enable these results.
背景/目的：在过去10年中，儿童肝移植的早期患者预后有了显著改善。目前小儿肝移植的总体预后很有前景。
在本研究中，我们回顾了在我们中心进行的所有小儿肝移植的结果，并分析了我们小儿肝移植的经验。34例肝移植受者中，26例为高度紧急情况（19.7%）。
6个月、12个月和36个月的精算患者生存率分别为82.9%、79.8%和72.2%。肝移植的指征为胆道闭锁（n = 22）、威尔逊病（n = 4）、糖原贮积病（n = 3）、门静脉海绵样变性（PVCT）（n = 3）、暴发性肝衰竭（n = 1）和隐源性肝硬化（n = 1）。主要并发症为手术并发症（包括胆道并发症、门静脉或动脉并发症、肠穿孔、术后出血，其中20%需要再次手术）和感染。环孢素是70.6%患者使用的主要免疫抑制剂，前6个月急性移植物排斥反应发生率为26.5%。1例儿童因肝动脉血栓形成接受再次移植。9例儿童在随访期间死亡。他们与门静脉血栓形成（1例）、慢性排斥反应（1例）、败血症（1例）、移植后淋巴细胞增生性疾病（1例）等有关。
我们中心小儿肝移植的总体预后很有前景。移植后护理和受者监测的进展以及技术改进促成了这些结果。
