Aim: To determine the incidence of allograft and medical factors characterizing optimal patient outcomes 3 year or more after pediatric live-donor liver transplantation (LDLT). Methods: Children with a minimum of 3 year follow-up period after LDLT were reviewed in terms of ideal graft features and clinical outcomes including immunologic events and technical interventions retrospectively. Results: Between 1997 and 2015, 102 children received live-donor allografts. Overall Kaplan Meier patient and graft survivals are 92% and 89% respectively. Main indications were biliary atresia (n=49, 48%), acute hepatic necrosis (n=16, 16%) and metabolic diseases (n=10, 10%). Median recipient age was 1.1 years (range 0.03-24.9 years). We further analyzed 80 patients with a minimum of 3 year follow-up period. Five patients required re-transplantation. The post-operative surgical complications were: biliary stricture (n=19), hepatic artery thrombosis (n=2) and portal vein thrombosis (n=6). Acute cellular rejection was documented in 43 patients (53%) within the first 6 months after LDLT. Immunosuppressive monotherapy and immunosuppressive-free patients were achieved in 62% and 5% of the total respectively. Graft and extra-hepatic outcomes are shown in Table 1.

Conclusions: LDLT is a life-saving procedure with an excellent survival rate and outcomes for children. PTLD was the most common extra-hepatic morbidity but were not associated with graft or patient loss. Live donor transplantation may also allow for less immunosuppression requirements and morbidity over the long term.

CITATION INFORMATION: Celik N, Ganoza A, Vyas F, Squires J, Venkat V, Bond G, Soltys K, Sindhi R, Squires R, Humar A, Mazariegos G. Long-Term Outcomes in Pediatric Live-Donor Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).

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