title: Liver transplantation in childhood with more than 10 years of follow-up: analysis of a single-center experience.
abstract: 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.
authors: Liver Transplant Unit and Pediatric Surgery Department, Hospital Valle de Hebron, Barcelona, Spain. jbueno@vhebron.net
authors: J
authors: J
authors: Bueno
authors: A
authors: A
authors: Medina
authors: J
authors: J
authors: Ortega
authors: A
authors: A
authors: Escartin
authors: M
authors: M
authors: Bello
authors: I
authors: I
authors: Bilbao
authors: J
authors: J
authors: Balsells
authors: C
authors: C
authors: Margarit
mesh_terms: 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