title: [Pediatric liver transplantation--experience at Schneider Children's Medical Center].
abstract: BACKGROUND
  Introduction of segmental graft transplantation from living donors and split livers from cadaver donors has led to major advances in liver transplantation (LTx) in children.
  
  
  OBJECTIVE
  To report our initial experience with pediatric LTx performed at our center.
  
  
  METHODS
  Data collection on all children undergoing LTx between the years 1996-2003 including the analysis of the graft and patient survivals and reports of complications.
  
  
  RESULTS
  Forty LTx were performed in 38 children at the mean age of 6.2 years, including two retransplants. There were 15 whole liver allografts and 25 segmental grafts including: 12 living donor grafts, 5 splits and 8 reduced grafts from cadaver donors. At 40 months mean follow-up period, patient and graft survival were 81% and 72.5%, respectively. There was post-transplant mortality in seven cases--5 children died during the first month and two children passed away after 6 months (recurrent disease) and 14 months (metastatic tumor). Vascular complications included: one early and one late portal vein thrombosis (5%) and six cases of hepatic artery thrombosis (15%). In the latest group, 3 grafts were salvaged by thrombectomy and another 3 children underwent re-transplantation. There were two bile leaks (5%) and 6 bile duct strictures (15%). The bile-duct strictures were successfully corrected by surgery in one child and by transhepatic dilatation in another 4 children. One child remained with intrahepatic strictures in one of the two hepatic segments.
  
  
  CONCLUSIONS
  The use of segmental liver allografts enables the performance of pediatric liver transplantation in Israel. Gathered experience and enhanced skills will ensure improved results over time.
authors.affiliation: Department of Transplantation, Children's Gastroenterology Institute, Schneider Children's Medical Center, Petah Tikva, Israel. emor@clalit.org.il
authors.forename: Eytan
authors.initials: E
authors.lastname: Mor
authors.forename: Nathan
authors.initials: N
authors.lastname: Bar-Nathan
authors.forename: Ezra
authors.initials: E
authors.lastname: Shaharabani
authors.forename: Rachel
authors.initials: R
authors.lastname: Bergerin
authors.forename: Efrat
authors.initials: E
authors.lastname: Harlev
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
authors.forename: Rivka
authors.initials: R
authors.lastname: Shapiro
mesh_terms: D000293:Adolescent; D002648:Child; D006085:Graft Survival; D006801:Humans; D007557:Israel; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology; D019520:Living Donors; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome