title: Experience of a successful pediatric liver transplant program in Mexico.
abstract: Orthotopic liver transplantation (OLT) has been very difficult to develop in Mexico and for many years its occurrence was anecdotal. This report presents the results of a pediatric liver transplant program, analyzing the variables that affect outcomes. Between June 1998 and March 2004, 35 OLT were performed in 34 recipients including 80% cadaveric whole-organ grafts and 20% segmental grafts, with 11% from cadaveric and 9% from living donors. Most of the recipients were infants or toddlers weighing less than 15 kg. There was only 1 case of arterial thrombosis (2.8%); the graft was saved with a Kasai procedure. Biliary complications were present in 22% of cases, all resolved with reoperations. Posttransplant cytomegalovirus infection or reactivation (28%), acute rejection (25%), or posttransplant lymphoproliferative disorders (5.7%) were not a cause of graft or patient loss. Overall, 1- and 5-year patient survival rates are 77.1% and 74.2%, respectively; however, when the 1998-2000 cohort was compared with the 2001-2004 cohort, there was a significant difference in survival (P = .004). The 1-year patient survival for the later group is 91.6%. We performed the first successful living donor liver transplantation and the first simultaneous liver-kidney transplantation in a child in our country. Our results demonstrate that pediatric liver transplantation is a feasible undertaking in Mexico, with survival rates comparable to those of foreign centers.
authors.affiliation: Department of Transplantation, Hospital Infantil de México Federico Gómez, México City, Mexico. varelafas@aol.com
authors.forename: G
authors.initials: G
authors.lastname: Varela-Fascinetto
authors.forename: R
authors.initials: R
authors.lastname: Dávila-Pérez
authors.forename: J
authors.initials: J
authors.lastname: Nieto-Zermeño
authors.forename: E
authors.initials: E
authors.lastname: Bracho-Blanchet
authors.forename: V
authors.initials: V
authors.lastname: Fuentes-García
authors.forename: P
authors.initials: P
authors.lastname: Castañeda-Martínez
authors.forename: M A
authors.initials: MA
authors.lastname: Abarca-García
authors.forename: V
authors.initials: V
authors.lastname: Olivar-López
authors.forename: R
authors.initials: R
authors.lastname: Caltenco-Serrano
authors.forename: H
authors.initials: H
authors.lastname: Palafox-Vázquez
authors.forename: J A
authors.initials: JA
authors.lastname: Hernández-Plata
authors.forename: J M
authors.initials: JM
authors.lastname: Tovilla-Mercado
authors.forename: P
authors.initials: P
authors.lastname: Lezama-del-Valle
authors.forename: P
authors.initials: P
authors.lastname: Valencia-Mayoral
mesh_terms: D002102:Cadaver; D002648:Child; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D019520:Living Donors; D008800:Mexico; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors