Namgoong Jung-Man, Hwang Shin, Kim Dae-Yeon, Ha Tae-Yong, Song Gi-Won, Jung Dong-Hwan, Park Gil-Chun, Kim Kyung Mo, Oh Seak Hee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Transplant. 2020 Dec 31;34(4):249-256. doi: 10.4285/kjt.20.0036. Epub 2020 Dec 16.
We investigated the incidence and outcomes of pediatric deceased donor liver transplantation (DDLT) using whole liver grafts in a high-volume liver transplantation (LT) center.
The study was a retrospective single-center analysis of whole LT in pediatric recipients. The study period was set as 20 years between January 2000 and December 2019. We defined pediatric recipients and donors to be aged ≤18 years.
During the study period, there were 98 cases of pediatric DDLT, and 34 patients (34.7%) received whole liver grafts. The age range of the deceased donors was 3 months to 56 years and that of pediatric recipients was 7 months to 17 years. Common primary diseases for LT were biliary atresia in 13, acute liver failure in four, Wilson disease in four, congenital portal vein agenesis in three, and genetic metabolic diseases in three. Pediatric-to-pediatric and adult-to-pediatric whole LTs were 22 (64.7%) and 12 (35.3%), respectively. A good correlation was noted between the donor and the recipient's body weight, and the recipient's body weight and allograft's weight. Graft and overall patient survival rates were 91.2% and 91.2% at 1 year, 88.0% and 88.0% at 3 years, and 88.0% and 88.0% at 5 years, respectively.
The results of this study revealed that Korean Network for Organ Sharing (KONOS) regulations with donor-recipient body weight matching exhibited good performance. Considering the reciprocal trades of liver organs among pediatric and adult donors and recipients, it is necessary to establish a policy for pediatric donor liver grafts to pediatric recipients on a priority basis.
我们在一个大容量肝脏移植（LT）中心研究了使用全肝移植物进行小儿尸体供肝肝移植（DDLT）的发生率和结果。
本研究是对小儿受者全肝移植的单中心回顾性分析。研究期间设定为2000年1月至2019年12月的20年。我们将小儿受者和供者定义为年龄≤18岁。
在研究期间，有98例小儿DDLT，34例患者（34.7%）接受了全肝移植物。尸体供者的年龄范围为3个月至56岁，小儿受者的年龄范围为7个月至17岁。LT的常见原发性疾病为胆道闭锁13例、急性肝衰竭4例、威尔逊病4例、先天性门静脉缺如3例、遗传代谢疾病3例。小儿对小儿和成人对小儿的全肝移植分别为22例（64.7%）和12例（35.3%）。供者与受者体重、受者体重与同种异体移植物重量之间存在良好的相关性。移植物和患者总体生存率在1年时分别为91.2%和91.2%，3年时分别为88.0%和88.0%，5年时分别为88.0%和88.0%。
本研究结果表明，韩国器官共享网络（KONOS）关于供受者体重匹配的规定表现良好。考虑到小儿和成人供受者之间肝脏器官的相互交易，有必要优先制定针对小儿受者的小儿供肝移植物政策。
