Liver transplantation in childhood with more than 10 years of follow-up: analysis of a single-center experience.
We pioneered pediatric liver transplantation (OLT) in Spain (June 1985). The aim of this study was to evaluate the current status of our OLT recipients with more than 10 years follow-up.


METHODS
The 50 patients with >10 years follow-up had a mean age at OLT of 5.6 years with 60% showing a main indication of biliary atresia. All but one (tacrolimus) received cyclosporine.


RESULTS
No patient loss occurred among these patients. Eighteen patients had follow-up >15 years and 12 >20 years. The incidence of acute rejection was 56%; chronic rejection, 16%; and lymphoproliferative disorders, 12%. Seven (14%) required retransplantation at a mean of 4.2 years after the first OLT due in four instances to chronic rejection. After 10 years of follow-up, one patient developed portal vein thrombosis and three biliary strictures. All patients remain on immunosuppression. In 64% cyclosporine was switched to tacrolimus or another agent. One patient developed acute rejection at 19.2 years. In 14% of patients the liver function test is abnormal with serum creatinine is >1.5 mg/dL in 10%; one requires insulin and three, antihypertensive drugs. Noncompliance with medications was detected in 10%. Three recipients had offspring.


CONCLUSIONS
OLT was an effective treatment with a good quality of life also on long-term follow-up.
Bueno
J
J
Liver Transplant Unit and Pediatric Surgery Department, Hospital Valle de Hebron, Barcelona, Spain. jbueno@vhebron.net
Medina
A
A
Ortega
J
J
Escartin
A
A
Bello
M
M
Bilbao
I
I
Balsells
J
J
Margarit
C
C
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors