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Liver transplantation in children with fulminant hepatic failure: The UCL experience
Author(s) -
Mahadeb Parikshat,
Gras Jérémie,
Sokal Etienne,
Otte JeanBernard,
Lerut Jan,
Detaille Thierry,
De Cléty Stéphan Clément,
Reding Raymond
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01008.x
Subject(s) - medicine , fulminant hepatic failure , liver transplantation , perioperative , fulminant , transplantation , surgery , pediatrics
The outcome of pediatric LT for FHF was shown to be poor in our center. To better understand such results, recipient and transplant parameters with a putative impact on post‐transplant outcome were analyzed in LT for FHF. Between March 1984 and June 2002, 33 children with FHF received a primary liver allograft. The overall results in this series were studied with respect to pre‐operative demographic and metabolic variables, peri‐operative events, and outcome. Five‐yr patient and graft survivals were 71% and 66%, respectively, with a retransplantation rate at 18%. Incidences of perioperative hemorrhage, of HAT and PVT were 14%, 8%, and 4%, respectively. Five‐yr acute rejection‐free survival rate was 55%. These data confirm the worse outcome following LT for FHF when compared with LT in elective, non‐malignant indications such as BA; results in FHF could not be related to surgical or immunological complications in the post‐transplant period and it is hypothesized that the MOF associated with FHF contributes to early post‐transplant mortality which would justify special management, including aggressive renal and hepatic support.