Introduction: Transplantation has provided tremendous progress for pediatric patients with liver failure.We determined the survival benefit for pediatric patients as reported to UNOS.

Methods: In this analysis of UNOS data, we reviewed the records of a total of 14,623 pediatric patients listed for primary liver transplant alone. Children who received a living donor transplant (n=1,478) were excluded from analysis. Of the remaining 13,174 cases, 10,174 children underwent transplant; the remaining 2,690 children were either still waiting or died on the waiting list. We categorized the children according to their diagnosis as: Biliary Atresia (BA) (38%), Cirrhosis (17%), Fulminant Liver Failure (FLF)(15%), Metabolic Disease (MD) (12%), Liver Tumor (LT) (6%) and others (12%).

The primary outcome was patient death. Patient survival on the waitlist and after transplant was computed according to Kaplan from the time of first listing.

Results: Waitlist survival was dependent on underlying disease. 1-yr patient survival (transplanted children were censored) was: for MD 92%; BA 92%; Cirrhosis 91%;FLF 64%; LT 64%; others 53%. 5-year patient survival transplanted children was: for MD 90%; BA 88%; Cirrhosis 88%; FLF 77%; LT 75%; others 80%.

Table 1 shows the total and the average life-years saved. The highest number of total years saved was for chronic diseases (MD, BA), where there was time to find a perfect donor. The total life-years saved for the more acute diagnoses (FLF, LT) are also favorable. However, the average life-years saved were higher for acute than chronic diseases.

Conclusion: The number of life-years saved was dependent on waitlist mortality. It was lower for chronic than for acute diseases. Because the mortality of a liver tx is relatively high, the number of life-years saved is relatively low for pediatric liver tx recipients. The average life-years saved were higher for acute than chronic diseases.

CITATION INFORMATION: Gruessner R, Gruessner A. Life-Years Saved After Pediatric Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

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