Long-Term Outcomes in Pediatric Live-Donor Liver Transplantation.
1Hillman Center for Pediatric Transplantation, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
2Thomas E. Starzl Transplantation Institute, Department of Surgery at UPMC, Pittsburgh, PA
3Division of Pediatric Gastroenterology, CHP of UPMC, Pittsburgh, PA.
Meeting: 2016 American Transplant Congress
Abstract number: D199
Keywords: Immunosuppression, Liver transplantation, Pediatric
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
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.
Patient eligible for analysis | n (%) meeting criteria | |
Graft related | ||
No re-transplantation | 80 | 75 (94%) |
Lack of chronic rejection | 58 | 58 (100%) |
No biliary intervention | 80 | 57 (71%) |
No vascular intervention | 80 | 71 (89%) |
ALT, <60 IU/L | 74 | 63 (85%) |
Total bilirubin, ≤1 mg/dL | 74 | 57 (71%) |
Albumun, ≥3 g/dL | 74 | 63 (85%) |
GGT, <75 IU/L | 74 | 58 (78%) |
Extra-hepatic variables | ||
No PTLD | 80 | 76 (95%) |
Monotherapy or immunosuppressive-free | 74 | 54 (73%) |
No anti-diabetic medication | 74 | 66 (90%) |
No anti-hypertensive medication | 74 | 68 (92%) |
No anti-seizure medication | 74 | 68 (92%) |
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).
To cite this abstract in AMA style:
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. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/long-term-outcomes-in-pediatric-live-donor-liver-transplantation/. Accessed November 8, 2024.« Back to 2016 American Transplant Congress