title: Progress and outcomes of the first high-volume pediatric liver transplantation program in Saudi Arabia.
abstract: In 2010, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, established a dedicated Organ Transplant Center to overcome the inadequacy in transplantation care in the region. Due to the high need for solid organ transplantation in children, this center focused on pediatric transplantation. Between 2011 and 2013, a total of 112 pediatric liver transplantations have been performed in our center, mostly from living donors (n=103, 92%). Eight percent of transplants were performed from deceased donors (n=9). Of the 112 transplants, 38.4% of children were below one year of age. There was a predominance of genetic-metabolic disorders (48.2%) as indications for transplant. Extra-hepatic biliary atresia was the indication in only 29.5% of transplant cases. End-stage liver disease of unknown origin accounted for 7.1% of cases. The actuarial recipient and graft survival are 93% and 89%, respectively. In-hospital morbidities amounted to 17% for surgical complications (n=19) and 18% for medical complications (n=20). Seven percent of recipients developed biopsy proven rejection during hospital stay. Five patients died late after discharge suddenly at home or at peripheral hospitals for unknown reasons. Overall, this newly established pediatric liver transplantation program could develop into a high-volume pediatric liver transplantation center in a short period of time due to the high need for liver transplantation in the country. In contrast to the experience in western or eastern countries, there is a high rate of indications for metabolic/genetic disorders. The early results of patient and graft survival are convincing. The long-term outcomes were compromised by an insufficient general healthcare system and cultural barriers.
authors.forename: Asma
authors.initials: A
authors.lastname: Fayyad
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shagrani
authors.forename: Talal
authors.initials: T
authors.lastname: AlGoufi
authors.forename: Yasser
authors.initials: Y
authors.lastname: ElSheikh
authors.forename: Jessica
authors.initials: J
authors.lastname: Murray
authors.forename: Ahmad
authors.initials: A
authors.lastname: Elgohary
authors.forename: Mohamed
authors.initials: M
authors.lastname: AlSebayel
authors.forename: Martin
authors.initials: M
authors.lastname: Burdelski
authors.forename: Dieter C
authors.initials: DC
authors.lastname: Broering
mesh_terms: D000017:ABO Blood-Group System; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000401:mortality*; D006085:Graft Survival; D006650:Histocompatibility Testing; D006782:Hospitals, Special / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality* / Q000639:trends*; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D009017:Morbidity; D010372:Pediatrics; D012529:Saudi Arabia / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents