J Korean Pediatr Soc.
1998 May;41(5):622-632.
Living Related Donor Liver Transplantation in Children: Indication and Clinical Outcome
- Affiliations
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- 1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 3Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 5Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 6Department of Anesthesiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
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PURPOSE: Living related donor liver transplantation (LRLT) was introduced into our pediatric liver transplantation program as a response to the shortage of donors. This study was performed to evaluate the indication, complication and outcome of LRLT in children.
METHODS
From December, 1994 to May, 1997, a total of 20 LRLTs had been performed at Asan Medical Center for end-stage liver disease. The patients ranged in age from 6 months to 14 years (median : 1 year 4 months) and in body weight from 5.8 to 50.5kg (median : 9.8kg). The indications for transplantation were biliary atresia (11), Wilson disease (3), nonsyndromic intrahepatic bile duct paucity (2), Byler syndrome (1), cirrhosis (1), fulminant hepatitis (1) and posthepatectomy bile duct stricture (1). Among them 3 ABO blood group incompatibilities were included. The lateral segment or the left lobe of the liver was used for the graft. As for immunosuppression, cyclosporin A based immunosuppression was used for the initial 11 cases which later changed into FK506 based for the last 9 cases.
RESULTS
The actuarial survival rate of recipients was 90% for our cases. Two deaths occurred, one of whom died of acute respiratory distress syndrome due to respiratory syncytial virus infection on 51st postoperative day and the other died of gastrointestinal bleeding from Epstein- Barr virus infection and posttransplant lymphoproliferative disease on 11th postoperative month. No patient died of surgical complications. Acute rejection episodes were observed in 6 (5 among 11 cyclosporin A based immunosuppression and 1 among FK506 group) which were managed successfully. All donors (6 fathers and 14 mothers) are alive and well with normal activity.
CONCLUSION
We concluded that LRLT is a promising option for alleviating the shortage of livers for pediatric transplantation.
MeSH Terms
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Bile Ducts
Bile Ducts, Intrahepatic
Biliary Atresia
Blood Group Incompatibility
Body Weight
Child*
Chungcheongnam-do
Constriction, Pathologic
Cyclosporine
Fathers
Fibrosis
Hemorrhage
Hepatitis
Hepatolenticular Degeneration
Humans
Immunosuppression
Liver Diseases
Liver Transplantation*
Liver*
Living Donors
Respiratory Distress Syndrome, Adult
Respiratory Syncytial Viruses
Survival Rate
Tacrolimus
Tissue Donors*
Transplants
Cyclosporine
Tacrolimus
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