Living-related liver transplantation in pediatric patients.
BACKGROUND
Many developments in surgical technique, immunosuppression, and patient selection criteria have led to improved long-term patient and graft survival in pediatric patients receiving liver transplants. In this study, we examined the early results of 26 pediatric recipients who underwent 26 liver transplantations between January 2003 and December 2004 at our institution.


METHODS
The most common indications for liver transplantation were cholestasis in 10 patients (38.5%) and Wilson's disease in 8 (30.8%). Other indications were fulminant hepatic failure (4 patients, 15.4%), tyrosinemia (2 patients, 7.7%), Caroli disease (1 patient, 3.8%), and cryptogenic cirrhosis (1 patient, 3.8%). One recipient with Byler disease and two with tyrosinemia also had incidental hepatocellular carcinoma.


RESULTS
Of 26 patients, 24 (92.3%) underwent living-related liver transplantation and 2 (7.7%) underwent cadaveric transplantation. The medical records of all patients were retrospectively reviewed. Twenty-two of 26 survived with excellent graft function, showing 91.2%, 86.4%, and 81.6% at 3, 12, and 24 months graft and patient survival rates, respectively. Sixteen patients (61.5%) developed various morbidities with biliary and vascular complications being the most common. Four patients (15.3%) developed bile leaks. Four patients (15.3%) developed hepatic artery thromboses. Five patients (19.2%) developed life-threatening infections. Four patients (15.4%) died during the study period, three owing to infectious complications. The other patient died due to acute respiratory distress syndrome.


CONCLUSIONS
Despite technical difficulties and a donor organ shortage, the results of liver transplantation in pediatric patients with end-stage liver disease have demonstrated promising results at our institution.
Dalgic
A
A
Baskent University Hospital, Department of General, Surgery Ankara, Turkey.
Ozcay
F
F
Arslan
G
G
Emiroglu
R
R
Sozen
H
H
Moray
G
G
Karakayali
H
H
Bilgin
N
N
Haberal
M
M
D000293:Adolescent; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D005190:Family; D005260:Female; D006085:Graft Survival; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007223:Infant; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D017093:Liver Failure / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008499:Medical Records; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods