Long-term outcomes of pediatric living donor liver transplantation at a single institution.
There have only been a few studies on the long-term outcomes and prognostic factors after pediatric LDLT. We conducted a retrospective, single-center assessment of the outcomes as well as the demographic and clinical factors that influenced the poor outcomes in 113 children aged <16 (median age 21 months; 6 months-15.5 yr) who underwent 115 LDLTs, predominantly for biliary atresia (60.9%) and FHF (14.8%), between 1994 and 2006 at Asan Medical Center. Left lateral segment or left lobe grafts were implanted into most of these children (86.9%) according to routine procedures. The overall rates of graft survival at one, five, and 10 yr were 89.6%, 83.0%, and 81.5%, respectively, and the overall rates of patient survival were 92.9%, 86.3%, and 84.8%, respectively. Virus-related disease (41.2%) and chronic rejection (29.4%) were the major causes of mortality. On multivariate analysis, UNOS status 1a and 1b and chronic rejection were significant risk factors for both graft and patient loss, whereas the PELD score >25 was a significant risk factor for graft loss. Patient and graft survival may be related not only to post-operative complications, but also to the patient's preoperative clinical condition.
Oh
Seak Hee
SH
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Kyung Mo
KM
Kim
Dae Yeon
DY
Lee
Yeoun Joo
YJ
Rhee
Kang Won
KW
Jang
Joo Young
JY
Chang
Soo Hee
SH
Lee
Sun Youn
SY
Kim
Joon-Sung
JS
Choi
Bo Hwa
BH
Park
Sung-Jong
SJ
Yoon
Chong Hyun
CH
Ko
Gi-Young
GY
Sung
Kyu-Bo
KB
Hwang
Gyu-Sam
GS
Choi
Kyu-Taek
KT
Yu
Eunsil
E
Song
Gi-Won
GW
Ha
Tae-Yong
TY
Moon
Deok-Bog
DB
Ahn
Chul-Soo
CS
Kim
Ki-Hun
KH
Hwang
Shin
S
Park
Kwang-Min
KM
Lee
Young-Joo
YJ
Lee
Sung-Gyu
SG
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000401:mortality / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D010372:Pediatrics / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome