Choosing a pediatric recipient for orthotopic liver transplantation.
Between March 3, 1981, and June 1, 1984, 216 children were evaluated for orthotopic liver transplantation. Of the 216 patients, 117 (55%) had received at least one liver transplant by June 1, 1985. Fifty-five (25%) died before transplantation. The 117 patients who received transplants were grouped according to severity of disease and degree of general decompensation at the time of transplantation. The severity of a patient's medical condition with the possible exception of deep hepatic coma, did not predict outcome following orthotopic liver transplantation. Seventy variables were assessed at the time of the evaluation. Twenty-three of the 70 variables were found to have prognostic significance with regard to death from progressive liver disease before transplantation. These 23 variables were incorporated into a multivariate model to provide a means of determining the relative risk of death among pediatric patients with end-stage liver disease. This information may allow more informed selection of candidates awaiting liver transplantation.
Malatack
J J
JJ
Department of Pediatrics, University of Pittsburgh Health Center, PA.
Schaid
D J
DJ
Urbach
A H
AH
Gartner
J C
JC
Zitelli
B J
BJ
Rockette
H
H
Fischer
J
J
Starzl
T E
TE
Iwatsuki
S
S
Shaw
B W
BW
D000553:Ambulatory Care; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D008107:Liver Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D016031:Liver Transplantation; D008297:Male; D008954:Models, Biological; D011379:Prognosis; D012307:Risk Factors