Clinical Experience of More Than 200 Cases of Pediatric Liver Transplantation at a Single Center: Improved Patient Survival

Backgrounds/AimsModel for End-stage Liver Disease (MELD) score was adopted in June 2016 in Korea.MethodsWe analyzed changes in volumes and outcomes of deceased donor liver transplantation (DDLT) for 1 year before and after introduction of MELD scoring at Asan Medical Center.ResultsThere were 64 cases of DDLT in 1 year before MELD introduction and 106 in 1 year after MELD introduction, an increase of 65%. The volume of DDLTs abruptly increased during first 3 months, but then returned to its usual level before MELD introduction, which indicated 3-month depletion of accumulated recipient pool with high MELD scores. The number of pediatric DDLT cases increased from 3 before MELD introduction to 11 after it, making up 21.4% and 47.8% of all cases of pediatric liver transplantation, respectively. The number of cases of retransplanted DDLTs increased from 4 to 27, representing 6.3% and 25.5% of all DDLT cases, respectively. The number of status 1 DDLT cases increased from 5 to 12, being 7.8% and 11.3% of all cases. Patient survival outcomes were similar before and after MELD introduction.ConclusionsThe number of DDLTs temporarily increased after adoption of MELD scoring due to accumulated recipient pool with high MELD scores. The numbers of retransplanted and pediatric DDLT cases significantly increased. Patient survival in adult and pediatric DDLT was comparable before and after adoption of MELD scoring. These results imply that Korean MELD score-based allocation system was successfully established within its first year.

show abstract

“…In fact, recent widening of donor indications for liver splitting appears to have contributed to the increase in pediatric DDLT cases. 11 12 …”

Section: Discussionmentioning

confidence: 99%

Successful introduction of Model for End-stage Liver Disease scoring in deceased donor liver transplantation in Korea: analysis of first 1 year experience at a high-volume transplantation center

Hwang

Song

et al. 2017

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

show abstract

“… 101 , 103 , 105 , 106 Acute cellular rejection is the most frequent histological abnormality (29.5%-48.7%). 102 Chronic rejection has a lower incidence, at 2% to 3.4%, 102 , 107 whereas in pediatric liver transplants overall rejection is reported at 5%. 108 Posttransplant lymphoproliferative disease has also been described with an incidence of 2.4% to 11.3%.…”

Section: Preamble and Methodsmentioning

confidence: 99%

The International Liver Transplantation Society Living Donor Liver Transplant Recipient Guideline

et al. 2017

View full text Add to dashboard Cite

Living donor liver transplantation (LDLT) has been increasingly embraced around the world as an important strategy to address the shortage of deceased donor livers. The aim of this guideline, approved by the International Liver Transplantation Society (ILTS), is to provide a collection of expert opinions, consensus, and best practices surrounding LDLT. Recommendations were developed from an analysis of the National Library of Medicine living donor transplantation indexed literature using the Grading of Recommendations Assessment, Development and Evaluation methodology. Writing was guided by the ILTS Policy on the Development and Use of Practice Guidelines (www.ilts.org). Intended for use by physicians, these recommendations support specific approaches to the diagnostic, therapeutic, and preventive aspects of care of living donor liver transplant recipients.

show abstract

“…If it is not possible to prevent metabolic decompensation, liver transplantation is an alternative therapeutic option [ 1 ]. As it is also now an accepted therapeutic option for non-metabolic, end stage liver diseases in children [ 2 , 3 ]. Favorable outcomes of cadaveric liver transplantation (LTx) for MLD have also been reported [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation for Metabolic Liver Disease: Experience at a Living Donor Dominant Liver Transplantation Center

Kim

et al. 2015

Pediatr Gastroenterol Hepatol Nutr

View full text Add to dashboard Cite

PurposeMetabolic liver disease (MLD) often progresses to life-threatening conditions. This study intends to describe the outcomes of liver transplantation (LTx) for MLD at a living donor-dominant transplantation center where potentially heterozygous carrier grafts are employed.MethodsWe retrospectively evaluated the medical records of 54 patients with MLD who underwent LTx between November 1995 and February 2012 at Asan Medical Center in Seoul, Korea. The cumulative graft and patient survival rates were analyzed according to patient age, and living or deceased donor LTx. Recurrence of the original disease was also investigated.ResultsThe post-transplant cumulative patient survival rates at one, five, and 10 years were 90.7%, 87.5% and 87.5%, and the graft survival rates were 88.8%, 85.5%, and 85.5%, respectively. There were no differences in the patient survival rates according to the recipient age, human leukocyte antigen matching, and living or deceased donor LTx. There were also no differences in the patient survival rates between the MLD and the non-MLD groups for children. Recurrence of the original metabolic disease was not observed in any patient during the follow-up period.ConclusionOur results suggest that the living donor-dominant transplantation program is well-tolerated in MLD without recurrence of the original MLD using all types of transplantation.

show abstract

Clinical Experience of More Than 200 Cases of Pediatric Liver Transplantation at a Single Center: Improved Patient Survival

Cited by 11 publications

References 10 publications

Successful introduction of Model for End-stage Liver Disease scoring in deceased donor liver transplantation in Korea: analysis of first 1 year experience at a high-volume transplantation center

Successful introduction of Model for End-stage Liver Disease scoring in deceased donor liver transplantation in Korea: analysis of first 1 year experience at a high-volume transplantation center

The International Liver Transplantation Society Living Donor Liver Transplant Recipient Guideline

Liver Transplantation for Metabolic Liver Disease: Experience at a Living Donor Dominant Liver Transplantation Center

Contact Info

Product

Resources

About