Surgical complications and long-term outcome in pediatric liver transplantation
Yamanaka, J.; Lynch, S.V.; Ong, T.H.; Fawcett, J.; Robinson, H.E.; Beale, K.; Balderson, G.A.; Strong, R.W.
Hepato-Gastroenterology 47(35): 1371-1374
2000
ISSN/ISBN: 0172-6390 PMID: 11100354 Document Number: 514059
Background/Aims: Liver transplantation has been widely accepted for the treatment of children with end-stage liver disease over the last 10 years particularly with the advent of reduced-size liver transplant technique. This study reviewed the perioperative and long-term results in the pediatric program of the Queensland Liver Transplant Service, Brisbane, Australia. Methodology: Retrospective analysis was performed in 153 children who received 176 liver grafts between 1985 and 1995, including 109 (62%) reduced-size and 67 (38%) whole liver grafts. Median follow-up period was 5.3 years. Results: One-, 5-, and 10-year patient and graft survival rates were 82% and 74%, 75% and 63%, and 70% and 60%, respectively. Normal physical and intellectual development was observed in 98% of survivors. There were no significant differences in patient or graft survival rates between transplants using reduced-size and whole liver grafts. Portal vein thrombosis was the most common vascular complication, occurring in 8%. Hepatic artery thrombosis occurred in 7%, including 11% of children less than 1 year old and 8% of those under 10kg. Biliary complication was found in 16% and posttransplant gastrointestinal perforation in 19%. Conclusions: Liver transplantation has the potential to cure and allow development in children with end-stage liver disease.