Jara Vega P, Díaz Fernández M C, Hierro Llanillo L, de la Vega Bueno A, Camarena Grande C, Alvarez Cienfuegos J, Vázquez González C
Hepatología (Unidad de Gastroenterología), Hospital Infantil La Paz, Madrid.
An Esp Pediatr. 1989 Jul;31(1):19-24.
Liver transplantation in children offers a therapeutic alternative for severe liver disease. Post-transplantation five-year survival reaches 76%. At the moment this technique must be indicated as a controversial subject, which requires considering both the severity of liver disease and scarcity of donors, with unpredictable waiting time. We report our experience after the study of 57 children selected for liver transplant. Their diagnosis, clinical and functional stage, situations considered as contraindications, and pre-transplantation management aimed at supporting candidates during waiting time and to diminish avoidable risks after surgery, is described. During waiting time, 15.9% of the patients died. Post-transplantation actuarial survival in our center is 63.6% (January 1986 to November 1988). Survival has markedly improved, reaching 81%, in the last 23 months in relation to a prophylactic approach of cytomegalovirus disease and performance of retransplantation in cases of severe graft dysfunction.
儿童肝移植为严重肝脏疾病提供了一种治疗选择。移植后五年生存率达76%。目前，这项技术必须被视为一个有争议的话题，这需要同时考虑肝脏疾病的严重程度和供体的稀缺性，以及不可预测的等待时间。我们报告了对57名选定进行肝移植的儿童进行研究后的经验。描述了他们的诊断、临床和功能分期、被视为禁忌证的情况，以及旨在在等待期间支持候选者并降低术后可避免风险的移植前管理。在等待期间，15.9%的患者死亡。我们中心移植后的精算生存率为63.6%（1986年1月至1988年11月）。在过去23个月里，由于采取了预防巨细胞病毒疾病的方法以及对严重移植物功能障碍病例进行再次移植，生存率显著提高，达到了81%。
