title: Comparative study between living and cadaveric donors in pediatric liver transplantation.
abstract: We examined whether the results in living-related hepatic transplantation (LRLT) are better than those from a cadaveric donor (CDLT).
  
  
  METHODS
  The last 27 consecutive LRLT, performed from 1998 to 2005, were compared with 27 CDLT matched for age, weight, date, and diagnosis. Grafts in LRLT group were left lateral segment (n = 22), left lobe (n = 3), and right lobe (n = 2). In the CDLT group, the grafts were split in situ (n = 10), hepatic reduction (n = 9) and whole liver (n = 8). We analyzed the actuarial survivals (grafts and children), retransplantation, primary nonfunction, initial graft malfunction (liver enzymes >2000 U/L), surgical complications, rejection, and resource consumption.
  
  
  RESULTS
  Patient survivals at 6 months, 1 year, and 5 years were 100%, 96%, and 96% in LRLT and 100%, 100%, and 100% in CDLT (P = NS). Graft survivals were 93%, 89%, and 89% versus 96%, 96%, and 96%, respectively (P = NS). Complications were biliary complications (LRLT, 25% vs CDLT, 3%; P = .021); portal vein thrombosis (LRLT, 7% vs CDLT, 3%; NS), and hepatic artery thrombosis (LRLT, 0% vs CDLT, 3%; NS). The overall incidence of acute rejection was slightly higher (NS) in LRLT (LRLT, 18% vs CDLT, 11%; NS). Liver enzyme levels were higher in the CDLT group, but initial malfunction rate was not statistically different. Regarding resource consumption: blood product needs were higher in LRLT (P < .05) and hospital stay and ICU stay were longer, although not significantly, among LRLT.
  
  
  CONCLUSIONS
  The results in LRLT among children are similar to those obtained in CDLT. We found a trend towards less initial graft malfunction in LRLT. Blood product needs were higher in LRLT. Hospital and ICU stay were longer, but not significantly different in LRLT. The benefits of LRLT are saving a scarce resource: a cadaveric donor liver graft.
authors.affiliation: Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: F Hernández
authors.initials: FH
authors.lastname: Oliveros
authors.forename: M López
authors.initials: ML
authors.lastname: Santamaría
authors.forename: M
authors.initials: M
authors.lastname: Gámez
authors.forename: J
authors.initials: J
authors.lastname: Murcia
authors.forename: N
authors.initials: N
authors.lastname: Leal
authors.forename: E
authors.initials: E
authors.lastname: Frauca
authors.forename: L
authors.initials: L
authors.lastname: Hierro
authors.forename: C
authors.initials: C
authors.lastname: Camarena
authors.forename: A
authors.initials: A
authors.lastname: de la Vega
authors.forename: G
authors.initials: G
authors.lastname: Bortolo
authors.forename: M C
authors.initials: MC
authors.lastname: Díaz
authors.forename: P
authors.initials: P
authors.lastname: Jara
mesh_terms: D001835:Body Weight; D002102:Cadaver; D002675:Child, Preschool; D005190:Family; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D012086:Reoperation / Q000706:statistics & numerical data; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome