title: Improved outcomes in pediatric liver transplantation for acute liver failure.
abstract: OLT is a life-saving option for ALF.
  
  
  OBJECTIVE
  To evaluate our outcomes in pediatric OLT for ALF.
  
  
  METHODS
  Retrospective review of our data between 1992 and 2007.
  
  
  RESULTS
  Of 142 children with ALF, 126 were listed, of which 40 spontaneously improved, nine died, and 77 underwent OLT (median waiting time four days). Fifty-three children received deceased donor grafts (34 whole and 19 split grafts), and there were 24 living donor grafts. The one- and five-yr patient survival was 87% and 80%, and graft survival 83% and 79%, respectively. Thirteen patients died after OLT, and there were nine retransplants in seven patients. Patient weight, length of stay, creatinine, and infection were significantly associated with death; increased weight and black ethnicity were associated with graft loss on univariate analysis, but not on multivariate analysis. There were no significant differences in patient survival (one and five yr), graft loss, or other complications between the groups.
  
  
  CONCLUSIONS
  We report the largest single-center study of OLT in pediatric ALF, demonstrating no difference in outcomes between different graft types. Our liberal use of segmental grafts may allow earlier OLT in this high-risk cohort and contribute to our excellent outcomes.
authors.affiliation: Department of Pediatrics and Recanati Miller Transplant Institute, Department of Surgery, Mount Sinai Hospital, New York, NY, USA. tamir.miloh@mountsinai.org
authors.forename: Tamir
authors.initials: T
authors.lastname: Miloh
authors.forename: Nanda
authors.initials: N
authors.lastname: Kerkar
authors.forename: Sanobar
authors.initials: S
authors.lastname: Parkar
authors.forename: Sukru
authors.initials: S
authors.lastname: Emre
authors.forename: Rachel
authors.initials: R
authors.lastname: Annunziato
authors.forename: Carlos
authors.initials: C
authors.lastname: Mendez
authors.forename: Ronen
authors.initials: R
authors.lastname: Arnon
authors.forename: Frederick
authors.initials: F
authors.lastname: Suchy
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Rodriguez-Laiz
authors.forename: Juan
authors.initials: J
authors.lastname: Del Rio Martin
authors.forename: Mark
authors.initials: M
authors.lastname: Sturdevant
authors.forename: Kishore
authors.initials: K
authors.lastname: Iyer
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D010372:Pediatrics / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult