Long-Term Graft Outcome of Pediatric Liver Transplantation in Copenhagen: Analysis of the First 51 Cases

Abstract

Background: Graft loss after liver transplantation remains a significant problem, especially in pediatric patients. The aim of this study was to assess our initial series of pediatric liver transplantation and to identify the risk factors that influence graft outcome. Methods: The first 51 transplantations were analyzed retrospectively. All transplantations were stratified into three groups according to graft type (full-size, reduced-size, and living-related-donor graft). Survival data of the grafts were stratified and multivariate analysis conducted with respect to preoperative and surgical factors. Results: Seventeen of all the transplants were full-size grafts and 34 technical-variant grafts (27 reduced-size grafts from cadavers and 7 living-related-donor grafts). The overall graft survival rates were 65, 62 and 53% at 1, 3 and 5 years, respectively. Twenty-three of 51 grafts (45%) were lost. Poor status of the recipients (hospitalization or intensive care unit care before surgery), a retransplanted graft, and a reduced-size graft were independent risk factors for graft failure. With experience, overall graft survival has improved significantly and the differences in graft survival between graft types have disappeared. Conclusions: To improve graft survival after pediatric liver transplantation, the timely referral of potential recipients to the transplant team and employing a meticulous technique during the operation, particularly for the technical-variant graft, are required.

Long‐term Outcomes of Pediatric Living Versus Deceased Donor Liver Transplantation Recipients: A Systematic Review and Meta‐analysis

“…The baseline characteristics of the included studies are presented in Table 1. ( 5‐28 ) All of these studies were included in the systematic review; however, 15 studies with overlapping cohorts were excluded from the main meta‐analyses but may have been included in the sensitivity analyses. Outcome data were reported as 3‐year, 5‐year, and 10‐year posttransplantation patient and graft survival in acute and chronic liver failure.…”

“…If outcomes for recipients of a whole liver or split liver were reported, we utilized only survival from whole liver recipients to maintain uniformity with other studies that only reported whole liver DDLT. ( 5‐28 )…”

Outcomes of Technical Variant Liver Transplantation versus Whole Liver Transplantation for Pediatric Patients: A Meta-Analysis

“…The 13 articles [ 19 – 31 ] were published from 1994 to 2010 and included 3662 pediatric patients and 3801 transplantations. The studies were from nine countries, including the United States (3), Spain (3), France (1), Italy (1), Belgium (1), Brazil (1), Netherlands (1), Sweden (1) and Japan (1).…”