Long-term graft outcome of pediatric liver transplantation in Copenhagen: analysis of the first 51 cases.
BACKGROUND
Graft loss after liver transplantation remains a significant problem, especially in pediatric patients. The aim of this study was to assess our initial series of pediatric liver transplantation and to identify the risk factors that influence graft outcome.


METHODS
The first 51 transplantations were analyzed retrospectively. All transplantations were stratified into three groups according to graft type (full-size, reduced-size, and living-related-donor graft). Survival data of the grafts were stratified and multivariate analysis conducted with respect to preoperative and surgical factors.


RESULTS
Seventeen of all the transplants were full-size grafts and 34 technical-variant grafts (27 reduced-size grafts from cadavers and 7 living-related-donor grafts). The overall graft survival rates were 65, 62 and 53% at 1, 3 and 5 years, respectively. Twenty-three of 51 grafts (45%) were lost. Poor status of the recipients (hospitalization or intensive care unit care before surgery), a retransplanted graft, and a reduced-size graft were independent risk factors for graft failure. With experience, overall graft survival has improved significantly and the differences in graft survival between graft types have disappeared.


CONCLUSIONS
To improve graft survival after pediatric liver transplantation, the timely referral of potential recipients to the transplant team and employing a meticulous technique during the operation, particularly for the technical-variant graft, are required.
Yamauchi
Yasushi
Y
Second Department of Surgery, Fukuoka University School of Medicine, Fukuoka, Japan. yyama@fukuoka-u.ac.jp
Yamashita
Yuichi
Y
Wettergren
Andre
A
Larsen
Peter N
PN
Rasmussen
Allan
A
Mikami
Koji
K
Shirakusa
Takayuki
T
Kirkegaard
Preben
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods; D019520:Living Donors; D008297:Male; D016019:Survival Analysis; D014019:Tissue Donors