Long term outcomes of pediatric liver transplantation according to age

J Korean Med Sci. 2014 Mar;29(3):320-7. doi: 10.3346/jkms.2014.29.3.320. Epub 2014 Feb 27.

Abstract

Liver transplantation (LT) has been the key therapy for end stage liver diseases. However, LT in infancy is still understudied. From 1992 to 2010, 152 children had undergone LT in Seoul National University Hospital. Operations were performed on 43 patients aged less than 12 months (Group A) and 109 patients aged over 12 months (Group B). The mean age of the recipients was 7 months in Group A and 74 months in Group B. The patients' survival rates and post-LT complications were analyzed. The mean Pediatric End-stage Liver Disease score was higher in Group A (21.8) than in Group B (13.4) (P = 0.049). Fulminant hepatitis was less common in Group A (4.8%) than in Group B (13.8%) (P = 0.021). The post-transplant lymphoproliferative disorder and portal vein complication were more common in Group A (14.0%, 18.6%) than in Group B (1.8%, 3.7%) (P = 0.005). However, the 1, 5, and 10 yr patient survival rates were 93%, 93%, and 93%, in Group A and 92%, 90%, and 88% in Group B (P = 0.212). The survival outcome of pediatric LT is excellent and similar regardless of age. LTs in infancy are not riskier than those of children.

Keywords: Fulminant Hepatitis; Liver Transplantation; Living Donors; Pediatrics; Survival Rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • End Stage Liver Disease / mortality
  • End Stage Liver Disease / surgery*
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival
  • Herpesviridae Infections / etiology
  • Humans
  • Infant
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / statistics & numerical data*
  • Lymphoproliferative Disorders / etiology*
  • Male
  • Proportional Hazards Models
  • Risk Factors
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome
  • Vascular Diseases / etiology