title: Thirty-five consecutive pediatric living donor liver transplantation: experiences and lessons learned from a single center.
abstract: OBJECTIVE
  In the last 10 years, the early patient outcome of liver transplantation in children have significantly improved. Now the overall outcomes of pediatric LT are promising.
  
  
  METHODS
  In this study, we review the outcome of all pediatric liver transplants performed at our center and analyze our experiences with pediatric liver transplant. Of the 34 liver transplant recipients, 26 were highly urgent (19.7%).
  
  
  RESULTS
  Actuarial patient survival rates at 6, 12, and 36 months was 82.9%, 79.8% and 72.2%, respectively. Indications for liver transplant were biliary atresia (n = 22), Wilson's disease (n = 4), glycogen storage disease (n = 3), portal vein cavernous transformation (PVCT) (n = 3), fulminant liver failure (n = 1), and cryptogenic cirrhosis (n = 1). The main complications were surgical complications (including biliary complications, portal vein or arterial complications, intestinal perforation, postoperative bleeding, of which 20% required reoperation) and infections. Cyclosporine was the primary immunosuppressive agent used in 70.6% of patients, with a 26.5% incidence of acute allograft rejection within the first six months. One children underwent re-transplant as a result of hepatic artery thrombosis. Nine children died during followup. They were related to portal vein thrombosis (one), chronic rejection (one), sepsis (one), post-transplant lymphoproliferative disease (one) and so on.
  
  
  CONCLUSIONS
  The overall outcomes of pediatric liver transplantation at our center are promising. Advances in post-transplant care and monitoring of the recipients, technical refinements enable these results.
authors.forename: Chun-Bao
authors.initials: CB
authors.lastname: Guo
authors.forename: Cong-Lun
authors.initials: CL
authors.lastname: Pu
authors.forename: Ying-Cun
authors.initials: YC
authors.lastname: Li
authors.forename: Ming-Man
authors.initials: MM
authors.lastname: Zhang
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Deng
authors.forename: Lv-Nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Quan
authors.initials: Q
authors.lastname: Kang
authors.forename: Xian-Qing
authors.initials: XQ
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000209:etiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008826:Microbial Sensitivity Tests; D011183:Postoperative Complications / Q000209:etiology / Q000382:microbiology