title: Results of pediatric living donor compared to deceased donor liver transplantation in the PELD/MELD era: Experience from two centers on two different continents.
abstract: The LDLT option in the pediatric population allows recipients to be transplanted early. A total of 202 consecutive pediatric liver transplants from two different institutions--108 (LDLT) and 94 (DDLT)--were retrospectively compared. Overall, one- and three-yr patient and graft survival were similar between DDLT and LDLT. ACR was greater in recipients of DDLT at one and three yr (50.8% and 61.0%) compared to LDLT (30.8% and 32.2%) (p = 0.002). When the data were stratified according to PELD/MELD score, LDLT with a low score had better one- and three-yr graft survival (96.2% and 96.2%) compared to DDLT (88.2% and 85.2%) (p = 0.02), with comparable patient survival (p = 0.75). Patient and graft survival were similar between DDLT and LDLT in the high PELD/MELD group. Lower incidence of ACR in both low and high PELD/MELD groups was (29.6% and 34.3%) for LDLT compared to DDLT (50.3% and 53.3%, p = 0.002 and p = 0.028, respectively). Regardless of PELD/MELD score, status, age group, and recipient weight, LDLT provides excellent patient and graft survival with a lower incidence of rejection compared to DDLT.
authors: Department of Surgery Division of Transplantation, University of Wisconsin, Madison, WI, USA.|Organ Transplantation Center, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Yucel
authors: Y
authors: Yankol
authors: Department of Surgery Division of Transplantation, University of Wisconsin, Madison, WI, USA.
authors: Luis A
authors: LA
authors: Fernandez
authors: Organ Transplantation Center, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Turan
authors: T
authors: Kanmaz
authors: Department of Surgery-Biostatistics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
authors: Glen E
authors: GE
authors: Leverson
authors: Department of Surgery Division of Transplantation, University of Wisconsin, Madison, WI, USA.
authors: Joshua D
authors: JD
authors: Mezrich
authors: Department of Surgery Division of Transplantation, University of Wisconsin, Madison, WI, USA.
authors: David
authors: D
authors: Foley
authors: Organ Transplantation Center, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Nesimi
authors: N
authors: Mecit
authors: Department of Surgery Division of Transplantation, University of Wisconsin, Madison, WI, USA.
authors: Anthony M
authors: AM
authors: D'Alessandro
authors: Organ Transplantation Center, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Koray
authors: K
authors: Acarli
authors: Organ Transplantation Center, Memorial Sisli Hospital, Istanbul, Turkey.
authors: Munci
authors: M
authors: Kalayoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents
keywords: MELD/PELD; living donor; outcome; pediatric liver transplantation