title: Liver transplantation for neonatal hemochromatosis: analysis of the UNOS database.
abstract: NH is the most common identifiable cause of ALF in the neonate. LT is the definitive treatment for neonates with NH who have failed medical therapy. Our aim was to determine the outcomes of LT in infants with NH. Patients (less than one yr of age) with NH who were listed for LT and patients who underwent LT between 1994 and 2013 were identified from the UNOS database for analysis. Risk factors for death and graft loss were analyzed by multivariate logistic regression. Thirty-eight infants with NH with a total of 43 transplants were identified. One- and five-yr patient and graft survival were 84.2%, 81.6%, 71.1%, and 68.4%, respectively. The outcomes for NH were not significantly different when compared to the same age-matched recipients with other causes of ALF. There were no statistically significant risk factors identified for graft loss or death. Ninety infants with NH were listed for LT. Reasons for removal included transplanted (49%), death (27%), too sick to transplant (7%), and improved status (13%). LT for infants with NH has a high rate of graft loss and death; however, outcomes are comparable to the same age-matched recipients with other causes of ALF.
authors.affiliation: Division of Pediatric Hepatology, Mount Sinai Medical Center, New York, NY, USA; Recanati/Miller Transplantation Institute, Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Shari
authors.initials: S
authors.lastname: Sheflin-Findling
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Annunziato
authors.forename: Jaime
authors.initials: J
authors.lastname: Chu
authors.forename: Antonios
authors.initials: A
authors.lastname: Arvelakis
authors.forename: Danielle
authors.initials: D
authors.lastname: Mahon
authors.forename: Ronen
authors.initials: R
authors.lastname: Arnon
mesh_terms: D016208:Databases, Factual; D005260:Female; D006084:Graft Rejection / Q000601:surgery; D006085:Graft Survival; D006432:Hemochromatosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists
keywords: acute liver failure; neonatal hemochromatosis; newborn; pediatric liver transplantation