title: Outcomes in infants listed for liver transplantation: A retrospective cohort study using the United Network for Organ Sharing database.
abstract: LT in neonates and young infants can be challenging due to a variety of factors. To describe the waitlist mortality rates and outcomes of patients listed and transplanted as infants identified from the UNOS database. Infants listed for LT between January 1985 and September 2010 were identified from the UNOS database. Mortality on the waitlist as well as outcomes post-LT was compared between infants aged ≤60 days (Group 1), 61-179 days (Group 2), and 180-364 days (Group 3). Of 6763 infants listed for LT (Group 1 n = 496, Group 2 n = 2404, Group 3 n = 3863), mean age at listing was 196 ± 87 days (Group 1, 29 ± 16 days; Group 2, 132 ± 32 days; Group 3, 257 ± 52 days). Waitlist mortality was highest in Group 1 (Group 1 vs. 3 HR 3.01, 95% CI 2.19-4.15, Group 2 vs. Group 3 HR 0.82, 95% CI 0.66-1.03). One- and five-yr graft survival was 59.6% and 42% (Group 1), 66% and 45% (Group 2), and 66.8% and 41% (Group 3) (one-yr survival p = 0.20; five-yr survival p = 0.19). Infants listed for LT at age ≤60 days had greater waitlist mortality risk than older infants. Infants undergoing LT at age ≤60 days had similar rates of patient and graft survival to older infants.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada. cajimenez@cheo.on.ca.
authors.forename: Carolina
authors.initials: C
authors.lastname: Jimenez-Rivera
authors.affiliation: Discipline of Paediatrics and Child Health, University of Newcastle, Newcastle, NSW, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: Nightingale
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.|Institute for Clinical Evaluative Sciences, Ottawa, ON, Canada.
authors.forename: Eric I
authors.initials: EI
authors.lastname: Benchimol
authors.affiliation: Hillman Center for Pediatric Transplantation Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: George V
authors.identifier: http://orcid.org/0000-0002-2624-8632
authors.initials: GV
authors.lastname: Mazariegos
authors.affiliation: Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: Vicky L
authors.initials: VL
authors.lastname: Ng
mesh_terms: D016208:Databases, Factual; D058625:End Stage Liver Disease / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016031:Liver Transplantation; D008297:Male; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013997:Time Factors; D061665:Time-to-Treatment; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: infant; liver transplantation