Liver transplantation in infants.
OBJECTIVE
In view of the earlier reports that children below 1 year of age constitute a high-risk group for liver transplantation, the authors reviewed their experience in performing orthotopic liver transplantation in this age group.


METHODS
The records of 9 children aged less than 1 year who underwent 6 living-related liver transplants and 3 reduced-size liver transplants between December 1993 and June 1997 were reviewed.


RESULTS
Five reexplorations were required for 3 children who had 1 or more of the following early complications: bleeding from hepatic vein to inferior vena cava anastomosis (n = 1), right hepatic vein stump bleeding (n = 1), intraabdominal hematoma (n = 2), jejuno-jejunostomy leakage (n = 1), and colonic perforation (n = 1). Late complications include stricture at the biliary-enteric anastomosis requiring percutaneous balloon dilatation (n = 3) and hepatitis of undetermined etiology requiring retransplantation (n = 1). There was no hepatic artery thrombosis despite the small arteries available for anastomosis. Follow-up ranged from 19 to 61 months (mean, 40 months). Patient survival rate was 100%, and graft survival with good liver function was 89%. All living donors, 2 fathers and 4 mothers, are well.


CONCLUSIONS
Liver transplantation in infants less than 1 year of age is technically demanding but feasible and still can be performed with a good outcome. Age alone (under 1 year) should not be considered as a contraindication for liver transplantation.
Saing
H
H
Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong.
Fan
S T
ST
Chan
K L
KL
Lo
C M
CM
Wei
W I
WI
Tsoi
N S
NS
Yuen
K Y
KY
Ng
I L
IL
Chau
M T
MT
Tso
W K
WK
Chan
J K
JK
Wong
J
J
D000367:Age Factors; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000151:congenital / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods* / Q000401:mortality; D008297:Male; D011379:Prognosis; D012042:Registries; D015996:Survival Rate; D016896:Treatment Outcome