Living Donor Liver Transplantation for Children With Biliary Atresia in the Pediatric End-Stage Liver Disease Era: The Role of Age and Insurance Status.
1Pediatrics, Mount Sinai Medical Center, NY, NY
2Recanati/Miller Transplantation Institute, Mount Sinai Medical Center, NY, NY
3Psychology, Fordham University, Bronx, NY.
Meeting: 2016 American Transplant Congress
Abstract number: D208
Keywords: Liver transplantation, Living-related liver donors, Pediatric, Survival
Session Information
Session Name: Poster Session D: Pediatric Liver Transplantation
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Lower socioeconomic status has been linked to inferior health outcomes. We have previously shown that children with biliary atresia (BA) who have public insurance (PU) have significantly worse patient and graft survival following deceased donor liver transplantation than children with private insurance (PR). Here we asked whether insurance status affects outcomes of living donor liver transplantation (LLT) in BA patients. Methods: Children with BA who underwent LLT between 1/2003 -6/2012 were identified from UNOS database. We studied the impact of insurance status on outcomes of young (age <2) and older (age 2-17 years) patients with BA.
Results: 302/1818 (16.8%) of transplanted BA patients underwent LLT, 262 at young age and 40 patients were older. 163/262 (62.2%) of the younger patient had PR and 86/262 (32.8%) had PU. Table 1 shows the characteristics of the younger age group by insurance type. 1,5 years patient survival (%) of the younger age group with PR was significantly better: 98.9, 98.4 in comparison 94.9, 93.9 of the younger age group with PU, P<0.01 for both time periods. 1,5 years graft survival of the younger patients with PR was slightly better but did not reach a statistical difference. There were no significant differences in outcomes between the younger and older patients and between older patients with BA with PR and PU. Conclusion: Young patients with BA and PR had a significantly better patient survival rate after LLT in comparison to their peers with LLT and PU. Studies are needed to identify targeted interventions to improve outcomes for patients with PU.
|
|
Private (N=186) |
Public (N=63) |
|
| Mean (SD) or % | Mean (SD) or % | P value | |
| Age (years) | 0.15 (0.36) | 0.29 (0.46) | 0.01 |
| Gender (% female) | 55.8 | 68.6 | 0.05 |
|
Ethnicity (%) White Hispanic Black
|
69.3 9.2 9.2
|
39.5 32.6 15.1
|
<0.01 |
| Albumin Gr/L | 3.0 (0.67) | 2.80 (0.67) | 0.03 |
| INR | 1.70 (0.8) | 1.67 (0.7) | 0.79 |
| PELD/MELD (median/range) |
17.00 (-10-50) |
19.00 (-5-50) |
0.71 |
| Status 1 | 3.7 | 5.8 | 0.44 |
| Donor age (years) | 32.4 (7.0) | 29.0 (8.5) | <0.01 |
| Donor gender (% female) | 52.8 | 67.4 | 0.03 |
| Donor BMI | 25.5(4.0) | 24.1 (3.6) | 0.01 |
CITATION INFORMATION: Chu J, Annunziato R, Aviles R, Arnon R. Living Donor Liver Transplantation for Children With Biliary Atresia in the Pediatric End-Stage Liver Disease Era: The Role of Age and Insurance Status. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Chu J, Annunziato R, Aviles R, Arnon R. Living Donor Liver Transplantation for Children With Biliary Atresia in the Pediatric End-Stage Liver Disease Era: The Role of Age and Insurance Status. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/living-donor-liver-transplantation-for-children-with-biliary-atresia-in-the-pediatric-end-stage-liver-disease-era-the-role-of-age-and-insurance-status/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress