title: Long-term outcomes of pediatric living donor liver transplantation at a single institution.
abstract: 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.
authors.affiliation: Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seak Hee
authors.initials: SH
authors.lastname: Oh
authors.forename: Kyung Mo
authors.initials: KM
authors.lastname: Kim
authors.forename: Dae Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Yeoun Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Kang Won
authors.initials: KW
authors.lastname: Rhee
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Soo Hee
authors.initials: SH
authors.lastname: Chang
authors.forename: Sun Youn
authors.initials: SY
authors.lastname: Lee
authors.forename: Joon-Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Bo Hwa
authors.initials: BH
authors.lastname: Choi
authors.forename: Sung-Jong
authors.initials: SJ
authors.lastname: Park
authors.forename: Chong Hyun
authors.initials: CH
authors.lastname: Yoon
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Gyu-Sam
authors.initials: GS
authors.lastname: Hwang
authors.forename: Kyu-Taek
authors.initials: KT
authors.lastname: Choi
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
authors.forename: Gi-Won
authors.initials: GW
authors.lastname: Song
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Ha
authors.forename: Deok-Bog
authors.initials: DB
authors.lastname: Moon
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Ahn
authors.forename: Ki-Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Shin
authors.initials: S
authors.lastname: Hwang
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Park
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: 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