Rehospitalization after pediatric living-donor liver transplantation.
BACKGROUND
Although rehospitalization is one of the factors affecting quality of life after successful liver transplantation, the effects of rehospitalization have not been assessed to date.


METHODS
Of 40 consecutive cases of pediatric living-donor liver transplantation (LDLT) performed between April 1994 and October 2000, 28 patients with a graft survival of more than 1 year were enrolled in this study to examine rehospitalization after successful LDLT. The rate and cause of rehospitalization were analyzed retrospectively on the basis of medical records.


RESULTS
A total of 23 of the 28 patients were rehospitalized. There were 84 episodes of rehospitalization. The mean number of rehospitalization days per episode per patient was 21.06 +/- 21.02 days. The rate of total rehospitalization days to the days after the hospitalization for LDLT was 6.56% +/- 8.73%. Rehospitalization episodes were attributable to the following: cholangitis (21.4%), viral infection (16.7%), and portal stenosis (PS) (13.1%). Rehospitalization as the result of rejection accounted for 9.5% of the episodes. The period of rehospitalization was long in the case of cholangitis (49.7 +/- 62.4 days), PS (13.8 +/- 13.4 days), and rejection (52.9 +/- 45.4 days). Although there were a lot of rehospitalization episodes as the result of viral infection subsequent to cholangitis, each rehospitalization period lasted 4.4 +/- 6.6 days.


CONCLUSIONS
It is suggested that prevention of cholangitis and PS, which were the causes of frequent and long rehospitalization periods, would result in a reduction of rehospitalization and therefore a better quality of life after pediatric LDLT.
Orii
Takashi
T
Department of Surgery, Sendai Shakaihoken Hospital, and Division of Advanced Surgical Science and Technology, Department of Surgery, Graduate School of Medicine, Tohoku University, Japan. orii-ltx@ya2.so-net.ne.jp
Ohkohchi
Nobuhiro
N
Satomi
Susumu
S
D000328:Adult; D002648:Child; D002675:Child, Preschool; D002761:Cholangitis / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014777:Virus Diseases / Q000453:epidemiology