Improved outcomes in pediatric liver transplantation for acute liver failure.

Abstract:

UNLABELLED:OLT is a life-saving option for ALF. AIM:To evaluate our outcomes in pediatric OLT for ALF. METHODS:Retrospective review of our data between 1992 and 2007. RESULTS:Of 142 children with ALF, 126 were listed, of which 40 spontaneously improved, nine died, and 77 underwent OLT (median waiting time four days). Fifty-three children received deceased donor grafts (34 whole and 19 split grafts), and there were 24 living donor grafts. The one- and five-yr patient survival was 87% and 80%, and graft survival 83% and 79%, respectively. Thirteen patients died after OLT, and there were nine retransplants in seven patients. Patient weight, length of stay, creatinine, and infection were significantly associated with death; increased weight and black ethnicity were associated with graft loss on univariate analysis, but not on multivariate analysis. There were no significant differences in patient survival (one and five yr), graft loss, or other complications between the groups. CONCLUSION:We report the largest single-center study of OLT in pediatric ALF, demonstrating no difference in outcomes between different graft types. Our liberal use of segmental grafts may allow earlier OLT in this high-risk cohort and contribute to our excellent outcomes.

journal_name

Pediatr Transplant

authors

Miloh T,Kerkar N,Parkar S,Emre S,Annunziato R,Mendez C,Arnon R,Suchy F,Rodriguez-Laiz G,Del Rio Martin J,Sturdevant M,Iyer K

doi

10.1111/j.1399-3046.2010.01356.x

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

863-9

issue

7

eissn

1397-3142

issn

1399-3046

pii

PTR1356

journal_volume

14

pub_type

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