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Long‐term outcomes of 600 living donor liver transplants for pediatric patients at a single center
Author(s) -
Ueda Mikiko,
Oike Fumitaka,
Ogura Yasuhiro,
Uryuhara Kenji,
Fujimoto Yasuhiro,
Kasahara Mureo,
Ogawa Kohei,
Kozaki Koichi,
Haga Hironori,
Tanaka Koichi
Publication year - 2006
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20826
Subject(s) - medicine , single center , abo blood group system , liver transplantation , cohort , surgery , abo incompatibility , multivariate analysis , fulminant hepatic failure , transplantation
This report concerns the long‐term outcome of living donor liver transplantation (LDLT) for pediatric patients at a single center. Between June 1990 and December 2003, a total of 600 LDLTs, including 568 primary transplantations and 32 retransplantations, were performed for pediatric patients, who were immunosuppressed with FK506 and low‐dose corticosteroids. Patient survival at 1, 5, and 10 years were 84.6%, 82.4%, and 77.2%, respectively, and the corresponding findings for graft survivals were 84.1%, 80.9%, and 74.5%. Multivariate analysis demonstrated that fulminant hepatic failure (FHF), a graft vs. body weight (GBWR) ratio of <0.8, and ABO‐incompatible transplants were independently associated with both patient and graft survival. The retransplantation rate was 6%, and 55 patients (9.7%) have been completely weaned off immunosuppressants. Long‐term patient and graft survival after pediatric LDLT for a large cohort of children at our hospital were found to be as good as those for cadaveric liver transplantation, although this series includes 13% liver transplantations with ABO‐incompatible donors, which are obviously inferior in patient and graft survival. To obtain better outcomes for patients with FHF and for patients with ABO‐incompatible transplants, immunosuppressive therapy needs to be improved. Liver Transpl 12:1326‐1336, 2006. © 2006 AASLD.