Document Detail


Pediatric living-donor liver transplantation for acute liver failure: analysis of 57 cases.
MedLine Citation:
PMID:  20158695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We reviewed 57 pediatric patients admitted with acute liver failure to Kyoto University Hospital in Japan over a period of 15 years to compare the etiology and the long-term outcome of infants and children after living donor liver transplantation (LDLT). Patients were divided into two groups according to age at the time of liver transplantation, infants group (<1 year, n = 20), and children group (1-18 years, n = 37). The overall survival rates were 73.6%, 69.5% and 67.2% at 1, 5, and 10 years after LDLT respectively. Age of recipients at the time of LDLT had a strong impact on their outcome, Children had significantly better outcome than infants (P = 0.001). Surgical complications were comparable between both groups. Infants had higher rates of acute cellular rejection (ACR), which was associated with features of hepatitis in many cases. Refractory ACR was the leading cause of death in eight out of 12 infants, while it resulted in loss of one child only. Cox's proportional hazard regression model was used to examine potential risk factors for graft loss and it shows that age <1 year was associated with high risk of graft loss [hazard ratio (HR) = 11.393; CI = 1.961-76.1763] (P < 0.05). In conclusion, Infants had poorer prognosis than children and refractory ACR was the leading cause of death. Using additional immunosuppressant for cases with severe and atypical rejections is recommended.
Authors:
Walid Mohamed El Moghazy; Yasuhiro Ogura; Minata Mutsuko; Kouji Harada; Akio Koizumi; Shinji Uemoto
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Publication Detail:
Type:  Journal Article     Date:  2010-02-16
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  23     ISSN:  1432-2277     ISO Abbreviation:  Transpl. Int.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  823-30     Citation Subset:  IM    
Affiliation:
Department of Hepatobiliary, Pancreas and Transplant Surgery, Kyoto University, Kyoto, Japan. moghazyw@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Distribution
Child
Child, Preschool
Female
Graft Rejection / mortality*
Graft Survival
Hepatitis / mortality
Humans
Infant
Japan / epidemiology
Liver Failure, Acute / mortality*,  surgery*
Liver Transplantation / mortality*
Living Donors / statistics & numerical data*
Male
Postoperative Complications / mortality
Prognosis
Risk Factors

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


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