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Life-Years Saved After Pediatric Liver Transplantation.

R. Gruessner, A. Gruessner.

SUNY Upstate Medical University, Syracuse, NY.

Meeting: 2016 American Transplant Congress

Abstract number: B178

Keywords: Liver transplantation, Pediatric

Session Information

Date: Sunday, June 12, 2016

Session Name: Poster Session B: Kidney Issue in Liver Transplantation

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

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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.

Category

 

N

Total Life-Years saved

Average Life-Years saved

Biliary Atresia

Waiting list

4967

–

 

Transplant

4418

1,994

0.45

Cirrhosis

Waiting list

2266

   

Transplant

1764

1,663

0.94

Fulminant

Waiting list

1995

–

 

Transplant

1577

1,878

1.19

   Metabolic     Disease

Waiting list

 

 

 

Transplant

1415

2,015

1.14

   Liver Tumors

Waiting list

705

 

 

Transplant

617

1,837

2.98

   Other

Waiting list

1612

 

 

Transplant

664

1,783

2.97

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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To cite this abstract in AMA style:

Gruessner R, Gruessner A. Life-Years Saved After Pediatric Liver Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/life-years-saved-after-pediatric-liver-transplantation/. Accessed March 4, 2021.

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