title: Liver transplantation in children using organs from young paediatric donors.
abstract: Nowadays, most paediatric liver transplant recipients receive a split or other technical variant graft from adult deceased or live donors, because of a lack of available age- and size matched paediatric donors. Few data are available, especially for liver grafts obtained from very young children (<6 years). We analysed all paediatric liver transplantations between 1989 and 2009. Recipients were divided into five groups (1-5) depending on donor age (<1, ≥1 to <6, ≥6 to <16, ≥16 to <45, ≥45 years). Overall, 413 paediatric liver transplantations from deceased donors were performed; 1- and 5-year graft survival rates were 75%, 80%, 78%, 81%, 74% and 75%, 64%, 70%, 67%, 46%, and 1- and 5-year patient survival rates were 88%, 91%, 90%, 89%, 78% and 88%, 84%, 84%, 83%, 63% for groups 1-5, respectively, without significant difference. Eight children received organs from donors younger than 1 year and 45 children received organs from donors between 1 and 6 years of age. Overall, vascular complications occurred in 13.2% of patients receiving organs from donors younger than 6 years. Analysis of our data revealed that the usage of liver grafts from donors younger than 6 years is a safe procedure. The outcome was comparable with grafts from older donors with excellent graft and patient survival, even for donors younger than 1 year.
authors.affiliation: Department of Hepatobiliary Surgery and Visceral Transplantation, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany. utaherden@gmail.com
authors.forename: Uta
authors.initials: U
authors.lastname: Herden
authors.forename: Rainer
authors.initials: R
authors.lastname: Ganschow
authors.forename: Andrea
authors.initials: A
authors.lastname: Briem-Richter
authors.forename: Knut
authors.initials: K
authors.lastname: Helmke
authors.forename: Bjoern
authors.initials: B
authors.lastname: Nashan
authors.forename: Lutz
authors.initials: L
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D016738:Alagille Syndrome / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002780:Cholestasis, Intrahepatic / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D016896:Treatment Outcome