title: Effect of small donor weight and donor-recipient weight ratio on the outcome of liver transplantation in children.
abstract: A small donor weight is a risk factor for HAT with potential for graft loss. To test this hypothesis, we evaluated outcomes of pediatric liver transplants utilizing donors <20 kg using the UNOS database from 01/2003 to 01/2012 (n = 1311). All isolated liver transplants with whole organ grafts were included. Recipients were divided into four groups based on donor weight: group 1, donor weight <5 kg (n = 34 [2%]); group 2, 5-10 kg (431 [33%]); group 3, 10-15 kg (560 [43%]); and group 4, 15-20 kg (286 [22%]). Actuarial patient survival for the first year post-transplant was significantly lower in groups 1 and 2 compared to groups 3 and 4 (p = 0.002), similarly the one-yr graft function (p < 0.0001). The difference was due to graft loss within the first month for groups 1 and 2. HAT was significantly higher in groups 1 and 2 compared to others (p = 0.0006). Logistic regression analysis demonstrated donor weight as the most predictive factor with analysis of the ROC curve showing a cutoff point at 7.8 kg. The donor-recipient weight ratio did, in none of the models, gain statistical significance.
authors.affiliation: Medstar Georgetown Transplant Institute, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Chirag S
authors.initials: CS
authors.lastname: Desai
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Angelika
authors.initials: A
authors.lastname: Gruessner
authors.forename: Thomas
authors.initials: T
authors.lastname: Fishbein
authors.forename: Stuart
authors.initials: S
authors.lastname: Kaufman
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006499:Hepatic Artery / Q000503:physiopathology; D006801:Humans; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D009929:Organ Size; D016016:Proportional Hazards Models; D012372:ROC Curve; D012042:Registries; D012044:Regression Analysis; D012307:Risk Factors; D013927:Thrombosis / Q000503:physiopathology*; D009927:Tissue and Organ Procurement
keywords: cadaveric donor; graft survival; hepatic artery thrombosis; liver allograft; pediatric liver transplant