Dr Mikiko Ueda and colleagues from Japan assessed the long-term outcome of living donor liver transplantation for pediatric patients.
Between June 1990 and December 2003, a total of 600 living donor liver transplantation were performed for pediatric patients at a single center.
These included 568 primary transplantations and 32 retransplantations.
The patients were immunosuppressed with FK506 and low-dose corticosteroids.
|Patient survival at 1 year was 85%|
The research team found that patient survival at 1, 5, and 10 years were 85%, 82%, and 77%, respectively.
The team observed that the corresponding findings for graft survivals at 1,5, and 10 years were 84%, 81%, and 75%.
Multivariate analysis demonstrated that fulminant hepatic failure, and a graft vs body weight ratio less than 1 was associated with both patient and graft survival.
The researchers noted that ABO-incompatible transplants was also independently associated with both patient and graft survival.
The retransplantation rate was 6%, and 10% of patients have been completely weaned off immunosuppressants.
Dr Ueda's team concludes, “Long-term patient and graft survival after pediatric living donor liver transplantation for a large cohort of children at our hospital were found to be as good as those for cadaveric liver transplantation.”
“However, 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 fulminant hepatic failure and for patients with ABO-incompatible transplants, immunosuppressive therapy needs to be improved.”