title: Establishment of a pediatric liver transplantation program: experience with 100 transplantation procedures.
abstract: OBJECTIVE
  To analyze the primary factors that influence the development and consolidation of a pediatric liver transplantation program.
  
  
  METHODS
  This was a retrospective study of 100 liver transplantation procedures performed in 84 pediatric patients between May 1990 and November 2007. The male-female ratio was 40:60. Mean (SD) age was 5 years (40 patients were younger than 2 years); cold ischemia time was 7.10 (3.1) hours; surgery time was 5.2 (2.2) hours; and time on the waiting list for transplantation was 75 (range, 1-1012) days. Indications for transplantation included cholestatic disease (43%), acute hepatic failure (AHF; 34%), metabolic disorders (14%), and cirrhosis (9%). Transplanted organs included 3 split grafts, 29 partial grafts, and 8 living-donor grafts.
  
  
  RESULTS
  Mean graft survival was 70.4%, 59.2%, and 58.1% at 1, 3, and 5 years, respectively. Factors that influenced graft outcome were age younger than 2 years; surgery time more than 6 hours; and AHF vs cholestatic disease, metabolic disorders, and cirrhosis. There were no significant differences in long-term (51% vs 59%) and short-term (71% vs 70%) graft survival between procedures performed in 1990-1998 compared with those performed in 1999-2007; however, there was a higher percentage (P = .005) of recipients at high risk (age younger than 2 years or with AHF) in the later period. All data were consistent with those of the European Liver Transplant Registry 2007.
  
  
  CONCLUSIONS
  A pediatric liver transplantation program can be established by a group experienced in liver transplantation.
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplantation, Reina Sofía University Hospital, Cordoba, Spain. rubenciria@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Ciria
authors.forename: J M
authors.initials: JM
authors.lastname: Sánchez-Hidalgo
authors.forename: J
authors.initials: J
authors.lastname: Briceño
authors.forename: A
authors.initials: A
authors.lastname: Naranjo
authors.forename: M
authors.initials: M
authors.lastname: Pleguezuelo
authors.forename: R
authors.initials: R
authors.lastname: Díaz-Nieto
authors.forename: A
authors.initials: A
authors.lastname: Luque
authors.forename: J
authors.initials: J
authors.lastname: Jiménez
authors.forename: E
authors.initials: E
authors.lastname: García-Menor
authors.forename: J J
authors.initials: JJ
authors.lastname: Gilbert
authors.forename: M
authors.initials: M
authors.lastname: de la Mata
authors.forename: J L
authors.initials: JL
authors.lastname: Pérez-Navero
authors.forename: G
authors.initials: G
authors.lastname: Solórzano
authors.forename: S
authors.initials: S
authors.lastname: Rufián
authors.forename: C
authors.initials: C
authors.lastname: Pera
authors.forename: P
authors.initials: P
authors.lastname: López-Cillero
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000145:classification / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods; D014850:Waiting Lists