[Liver transplantation in infants and children. Evaluation of the first 40 cases (March 1991-March 1997)].
BACKGROUND
Liver transplantation (LT) is the treatment of end-stage liver disease in children. We report our experience with LT using grafts from living related (LRD) and cadaver donors (CD).


METHODS
From March 1991 to March 1997, 40 children and infants received a total of 42 liver grafts. A reduced-size liver was used in 28 cases. We studied pre-transplantation status, survival rate, and medical and surgical complications in these patients.


RESULTS
The survival rate in our series was respectively 85 and 80% at 1 and 7 years after LT. Low weight infants required a prolonged ventilatory assistance. Five of the six deaths noticed during the first three months after LT occurred in children weighing less than 12 kg. One year after LT, no significant difference in the incidence of rejection was found, neither between low-weight children and the others, nor between patients transplanted from CD or LRD. Biliary tract stricture was the major surgical complication.


CONCLUSIONS
This series consisted of a majority of low-weight children. The survival rate in the patients weighting less than 12 kg is lower than in the others. This may be explained by the nutritional status of these patients and early postsurgical complications. The use of grafts from living donors offers more flexibility since the operation is performed electively, but it did not seem to modify the incidence of acute rejections and surgical complications.
Lachaux
A
A
Unité d'hépatogastroentérologie et nutrition pédiatriques, Hôpital Edouard-Herriot, Lyon, France.
Eid
B
B
Stamm
D
D
Gillet
Y
Y
Villard
F
F
Branche
P
P
Mamoux
V
V
Le Gall
C
C
Canterino
I
I
Le Derf
Y
Y
Bouvier
R
R
Boillot
O
O
D000293:Adolescent; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D009752:Nutritional Status; D014182:Transplantation, Autologous; D016896:Treatment Outcome