J Korean Med Sci.  2014 Mar;29(3):320-327. 10.3346/jkms.2014.29.3.320.

Long Term Outcomes of Pediatric Liver Transplantation According to Age

• Byun J
• Yi NJ
• Lee JM
• Suh SW
• Yoo T
• Choi Y
• Ko JS
• Seo JK
• Kim H
• Lee HW
• Kim HY
• Lee KW
• Jung SE
• Lee SC
• Park KW
• Suh KS

• KMID: 1734916
• DOI: http://doi.org/10.3346/jkms.2014.29.3.320

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.

Keyword

Pediatrics; Liver Transplantation; Survival Rate; Fulminant Hepatitis; Living Donors; Liver Transplantation

MeSH Terms

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

Figure

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  Fig. 1 Overall survival outcome of pediatric liver transplantation. (A) Graft survival rate. (B) Patient survival rate. YSR, year survival rate.

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  Fig. 2 The patient and graft survival outcomes of the two groups according to the age; less (infant) and more (children) than 12 months. (A) Graft survival rate. (B) Patient survival rate.

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