Rehospitalization after pediatric living-donor liver transplantation

Orii, Takashi; Ohkohchi, Nobuhiro; Satoh, Susumu

doi:10.1097/01.tp.0000116566.98067.7e

Cited by 5 publications

(4 citation statements)

References 22 publications

(35 reference statements)

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“…and Their et al. both reported that hospitalizations for infections were far more common than for rejection . Our findings differ from Orii et al., inasmuch as they report a much longer mean length of stay (21 days), primarily due to conditions unique to the liver transplant population (cholangitis, portal stenosis).…”

Section: Discussioncontrasting

confidence: 85%

Rehospitalization after pediatric heart transplantation: Incidence, indications, and outcomes

Hollander

McElhinney²,

Almond

et al. 2016

Pediatric Transplantation

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We report the patterns of rehospitalization after pediatric heart transplant (Htx) at a single center. Retrospective review of 107 consecutive pediatric Htx recipients between January 22, 2007, and August 28, 2014, who survived their initial transplant hospitalization. The frequency, duration, and indications for all hospitalizations between transplant hospitalization discharge and September 30, 2015, were analyzed. A total of 444 hospitalization episodes occurred in 90 of 107 (84%) patients. The median time to first rehospitalization was 59.5 (range 1-1526) days, and the median length of stay was 2.5 (range 0-81) days. There were an average of two hospitalizations per patient in the first year following transplant hospitalization, declining to about 0.8 per patient per year starting at 3 years post-transplant. Admissions for viral infections were most common, occurring in 93 of 386 (24%), followed by rule out sepsis in 61 of 386 (16%). Admissions for suspected or confirmed rejection were less frequent, accounting for 41 of 386 (11%) and 31 of 386 (8%) of all admissions, respectively. Survival to discharge after rehospitalization was 97%. Hospitalization is common after pediatric Htx, particularly in the first post-transplant year, with the most frequent indications for hospitalization being viral illness and rule out sepsis. After the first post-transplant year, the risk for readmission falls significantly but remains constant for several years.

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Section: Discussioncontrasting

confidence: 85%

Rehospitalization after pediatric heart transplantation: Incidence, indications, and outcomes

Hollander

McElhinney²,

Almond

et al. 2016

Pediatric Transplantation

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“…6 Liver transplant recipients also experience recurrent hospitalizations. Orii et al 7 reported an 82% rehospitalization rate among pediatric LTR (living donors) during a follow-up period of 3.9 years. Bacterial infection was the most common diagnosis, with viral infections followed by surgical complications.…”

Section: Introductionmentioning

confidence: 99%

“…Liver transplant recipients also experience recurrent hospitalizations. Orii et al 7 . reported an 82% rehospitalization rate among pediatric LTR (living donors) during a follow‐up period of 3.9 years.…”

Section: Introductionmentioning

confidence: 99%

Clinical profile of re‐hospitalizations in pediatric kidney and liver transplant recipients

Shohet,

Ziv,

Gavish

et al. 2023

Pediatric Transplantation

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BackgroundSolid organ transplantation has evolved in recent decades, resulting in a rise in patient and graft survival. Frequent hospitalizations affect graft function, patients' health, and quality of life. This study characterizes the frequency and causes of post‐transplant hospitalizations among pediatric recipients.MethodsThis is a retrospective observational study evaluating pediatric kidney transplant recipients (KTR) and liver transplant recipients (LTR) aged 0–21 years, followed at a tertiary pediatric center in Israel from 2012 to 2017. Data were collected starting at 60 days post‐transplantation. Diagnoses of admissions were based on clinical, laboratory, and radiographic findings.ResultsForty‐nine KTR experienced 199 all‐cause re‐hospitalizations (median number of re‐hospitalizations per patient – 3 (IQR [interquartile range] 1–5.5), while 351 re‐hospitalizations were recorded in 56 LTR (median – 5 [IQR 2–8.8]). Median follow‐up time was 2.2 years for KTR (IQR 1–3.9) and 3 years for LTR (IQR 2.1–4.1). The most common cause for hospitalization for both cohorts was infection (50.8% and 62%, respectively). Gram‐negative bacteria were the most common pathogens identified in KTR, while viral pathogens were more common in LTR (51% and 57% of pathogen‐identified cases, respectively).ConclusionsThis is the largest study to describe rehospitalizations for pediatric solid organ recipients. The hospital admission rate was higher in LTR in comparison to KTR. Infections were the most common cause of hospitalization throughout the whole study period in both populations. Frequent hospitalizations impose a heavy burden on patients and their families; better understanding of hospitalization causes may help to minimize their frequency.

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“…The child remains under close surveillance with daily blood tests and reviews. There is a low threshold to admit the child for investigation if blood results change or if infection or bile blockage is detected (Orii, Ohkohchi, & Satomi, 2004). For the first three months, the child must remain near to the hospital, especially if they live outside of Auckland.…”

Section: Paediatric Liver Transplantationmentioning

confidence: 99%

Through Mothers' Eyes: The Lived Experience of Caring for a Child who has Undergone and Recovered from a Liver Transplantation

Murphy¹

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<p>Paediatric liver transplantation is a complicated and costly procedure. It also has the potential to be life-changing for the child and family. Paediatric liver transplantation commenced in New Zealand in July 2001. Approximately six to eight New Zealand children require liver transplantation annually. International survival rates of children receiving a liver transplant have increased in association with effective drug therapy and technological advances, though the children experience varying levels of wellbeing. Children are discharged relatively quickly following their major surgery. Upon discharge the child is assessed to be well, exhibits satisfactory liver function and the social situation at home is assessed to be conducive to their ongoing care. On discharge the child remains under the spotlight of health care workers. Monitoring reduces as the child's condition improves. The child is only seen by health professionals in outpatient appointments or if admitted back to the ward. The close engagement in the hospital setting is untangled. The child, mother and family regain their autonomy. The long term implications of caring for a child recovering from a life-threatening condition to relative normalcy are largely unobserved. Mothers, whose children had undergone a liver transplant more than one year ago at time of interview and whose children were outpatients of Starship Children's Hospital, were invited to participate in this research. Mothers are generally the most common primary caregiver of children. In caring for their transplanted child following recovery, mothers are relied upon to provide information about their child's wellbeing and functioning. A Heideggerian hermeneutic phenomenological approach, informed by the work of van Manen (1990) was used. Three mothers of children who had received a liver transplant were interviewed to reveal the meanings of the phenomenon - what is the meaning of lived experience of mothers in caring for their child who has undergone and recovered following liver transplantation? Little previous study regarding mothers' lived experience of caring for their child, who had recovered from a liver transplant, was found in the literature. The emerging themes were punctuated with stress being a consistent feature. Utilising Ruddick's (1983) concepts of maternal thinking, the emerging themes were merged within the three interests governing maternal practice; preservation, growth and acceptability. The absolute capacity for attentive love draws the experience together. An essential theme identified out of the analysis was the concept of survival relating to the unique features of liver transplantation and the consequences of liver rejection and failure. The findings contribute to the understanding of the phenomenon, emphasising the need for good support systems for families of children who have undergone transplantation; assistance in the establishment of maternal coping strategies and regular feedback on the children's progress acknowledging the role and care provided by mothers. Health professionals might develop new understandings of the dynamic and evolving issues arising out of the provision of care by mothers. There may be a greater empathy and understanding of the experiences of mothers in their roles of caring. The findings provide glimpses of the life of children who have undergone and recovered from a liver transplant.</p>

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Rehospitalization after pediatric living-donor liver transplantation

Abstract: It is suggested that prevention of cholangitis and PS, which were the causes of frequent and long rehospitalization periods, would result in a reduction of rehospitalization and therefore a better quality of life after pediatric LDLT.

Cited by 5 publications

References 22 publications

Rehospitalization after pediatric heart transplantation: Incidence, indications, and outcomes

Rehospitalization after pediatric heart transplantation: Incidence, indications, and outcomes

Clinical profile of re‐hospitalizations in pediatric kidney and liver transplant recipients

Through Mothers' Eyes: The Lived Experience of Caring for a Child who has Undergone and Recovered from a Liver Transplantation

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