Document Detail


Pediatric liver transplantation
MedLine Citation:
PMID:  19577411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Liver transplantations (LT) performed in children aged younger than 16 years account for 6 to 8% of the total number of LT performed yearly in France. Indications for pediatric LT are mainly chronic cholestatic diseases of neonatal onset that lead to biliary cirrhosis; the most common is biliary atresia. Because most children are very young at transplantation (median age of 2 years), LT is performed in most cases with left lateral segments from a deceased donor or a related living donor. This increases the rate of postoperative vascular and biliary complications, compared with whole-liver transplantation. The principal early cause of death is sepsis. Some specific post-LT complications occur more frequently in young children than adolescents or adults: EBV-related post-transplantation lymphoproliferative disease and food allergies in young recipients treated with tacrolimus and acquired renal cystic disease, associated with renal dysfunction, mostly in children treated with cyclosporine. Despite the high rate of early post-LT complications, 10-year survival exceeds 70 to 80% and health-related quality of life is close to normal. Only about 10% of children will require a late retransplantation, mainly for chronic liver graft rejection, which most often results from poor or non-adherence to immunosuppressants, especially during adolescence.
Authors:
Dominique Debray; Olivier Bernard; Fr??d??ric Gauthier
Publication Detail:
Type:  English Abstract; Journal Article; Review     Date:  2009-07-03
Journal Detail:
Title:  Presse m??dicale (Paris, France : 1983)     Volume:  38     ISSN:  0755-4982     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2009-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8302490     Medline TA:  Presse Med     Country:  France    
Other Details:
Languages:  fre     Pagination:  1299-306     Citation Subset:  IM    
Affiliation:
Service d'h??patologie p??diatrique, H??pital Bic??tre, AP-HP, P??le adolescent-m??re-enfant, Le Kremlin-Bic??tre Cedex, France.
Vernacular Title:
Transplantation h??patique chez l'enfant.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Child
Child, Preschool
Cholestasis / surgery*
Chronic Disease
Graft Survival
Histocompatibility
Humans
Infant
Liver / anatomy & histology
Liver Failure, Acute / surgery*
Liver Transplantation* / adverse effects,  methods,  mortality
Metabolic Diseases / surgery*
Postoperative Complications / etiology
Quality of Life

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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