Pediatric Liver Transplantation: An Outcome Analysis of a 30-Year Single Center Experience
1Department for Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria
2Department of Paediatrics I, Innsbruck Medical University, Innsbruck, Austria.
Meeting: 2015 American Transplant Congress
Abstract number: D200
Keywords: Liver transplantation, Outcome, Pediatric
Session Information
Session Name: Poster Session D: Liver: Pediatrics
Session Type: Poster Session
Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Introduction: In this study we aim to assess factors influencing long-term patient and graft survival as well as surgical parameters and risk factors influencing organ function after pediatric liver transplantation.
Patients and Methods: We performed a retrospective analysis of 109 consecutive pediatric liver transplantations (LTx) between 1984 and 2014 at the Innsbruck Medical University. Kaplan-Meier and log-rank analyses were performed to assess 5- and 10-year patient and graft survival. The Cox proportional hazards model was used to determine predictors of outcome.
Results: A total of 54 deceased donor LTx, 15 deceased donor split-LTx, 37 LTx from living donors and 3 multivisceral transplantations performed in children between 3 months and 17 years were included in this study. The median follow-up is 9.13 years. Eleven LTx were retransplantations. Median recipient age was 2.94 years, median donor age was 23 years. The mean anhepatic period was 55.7 ± 20.2 min, and the mean cold ischemia time (CIT) was 6 ± 4.06 hours. After an initial 5-year patient and graft survival rate of 61.4% and 52.1% in the era between 1984 and 1994, the long-term increased to 88.3% and 90.5% graft and patient survival after 5 and 10 years (p=0.0008 and 0.0003) in the era from 2005 to 2014. Five and 10-year patient and graft survival after living-LTx were 97.3% and 94.5%.
Graft type, liver disease, donor or recipient age had no significant impact on long-term graft survival. Duration of the anhepatic period did not impact patient (p=0.439) and graft survival (p=0.354). A CIT above 6 hours, however, resulted in a significant lower patient (p=0.007) and graft (0.019) survival.. In the deceased donor subgroup, recipients younger than 5 years had a significant worse 5- and 10-year-outcome (69.6% and 61.9% vs. 88.6% and 83.9% patient survival, p=0.020; 63.2% and 55.3% vs. 85.7% and 81% graft survival, p=0.024).
Conclusion: Excellent long-term results could be achieved with liver transplantation in children during the last 30 years. Limited ischemia time, detailed surgical planning and close long-term monitoring are factors influencing the outcome.
To cite this abstract in AMA style:
Weissenbacher A, Margreiter C, Oberhuber R, Maglione M, Cardini B, Grahammer J, Müller T, Margreiter R, Schneeberger S. Pediatric Liver Transplantation: An Outcome Analysis of a 30-Year Single Center Experience [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pediatric-liver-transplantation-an-outcome-analysis-of-a-30-year-single-center-experience/. Accessed May 19, 2025.« Back to 2015 American Transplant Congress