Quality of life and problems affecting recipients more than 10 years after living donor liver transplantation.
BACKGROUND
We initiated living donor liver transplantation (LDLT) in 1991, allowing us to examine issues related to long-term survival. The aim of this study was to review the long-term outcomes of LDLT in children.


METHODS
We performed 116 LDLT from 1991 to present, including 17 recipients who survived >10 years. They were evaluated for growth, immunosuppressive therapy, complications, and quality of life (QOL).


RESULTS
The average age at LDLT was 5.4 years (range, 6 months to 17 years), with a present average age of 17.2 years (range, 11-28 years). At the time of LDLT, 6 recipients had growth retardation with body weights low for age by 2 standard deviations (SD). However, 4 of 6 recipients who underwent LDLT before age of 2 years caught up, reaching average heights and body weights for their ages. Among 6 recipients who were diagnosed with acute rejections by biopsy >5 years after LDLT, 5 improved after steroid pulse therapy. One recipient with a steroid-resistant acute rejection was administered deoxyspergualin after steroids. Chronic rejection was not observed in this series. One recipient has not required immunosuppressive therapy for >4 years with a good present condition.


CONCLUSIONS
The majority of LDLT recipients achieved a good QOL during long-term survival; they are pursuing normal studies.
Kawagishi
N
N
Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan. kawan@mail.tains.tohoku.ac.jp
Takeda
I
I
Miyagi
S
S
Satoh
K
K
Akamatsu
Y
Y
Sekiguchi
S
S
Satomi
S
S
D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006130:Growth Disorders / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000276:immunology* / Q000523:psychology; D019520:Living Donors; D008232:Lymphoproliferative Disorders / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011788:Quality of Life; D013997:Time Factors; D055815:Young Adult
D007166:Immunosuppressive Agents