The current United Network for Organ Sharing policy is to allocate liver grafts to pediatric patients with chronic liver disease.
The diagnosis is based on the pediatric end-stage liver disease scoring system.
Children with fulminant hepatic failure may be urgently listed as Status 1a.
Dr Martín Martín and colleagues from Los Angeles identified pre-transplant variables that influence patient and graft survival.
The research team assessed those children undergoing liver transplantion for fulminant hepatic failure.
|5 year patient survival was worse in those undergoing transplant for fulminant hepatic failure|
The team then compared the results to those patients transplanted for extrahepatic biliary atresia, a chronic form of liver disease.
The United Network for Organ Sharing Liver Transplant Registry was examined for pediatric liver transplants.
The team assessed liver transplants performed for fulminant hepatic failure, and extrahepatic biliary atresia from 1987 to 2002.
Variables that influenced patient and graft survival were assessed using univariate and multivariate analysis.
Kaplan-Meier analysis of fulminant hepatic failure and extrahepatic biliary atresia groups were conducted.
The researchers found that 5 year patient and graft survival were both worse in those who underwent transplantation for fulminant hepatic failure.
The team used multivariate analysis of 29 variables to identify sets of factors that influenced patient and graft survival for both groups.
Dr Martín's team concludes, “These results confirm that separate prioritizing systems for liver transplantation are needed for children with chronic liver disease and fulminant hepatic failure.”
“In addition, our findings illustrate that there are unique sets of variables which predict survival following liver transplantation for these 2 groups.”