Pediatric liver transplantation with cadaveric or living related donors: Comparative results in 90 elective recipients of primary grafts

Study design: Between July 1993 and March 1997, 110 children were listed for primary elective liver transplantation with cadaveric (Cad: n = 68) or living-related (LR: n = 42) donors. Pregraft mortality, post-transplant survival, and surgical and immunologic complications were retrospectively compar...

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Bibliographic Details
Published in:	The Journal of pediatrics Vol. 134; no. 3; pp. 280 - 286
Main Authors:	Reding, Raymond, de Ville de Goyet, Jean, Delbeke, Isabelle, Sokal, Etienne, Jamart, Jacques, Janssen, Magda, Otte, Jean-Bernard
Format:	Journal Article
Language:	English
Published:	New York, NY Mosby, Inc 01-03-1999 Elsevier Mosby-Year Book, Inc
Subjects:	Adolescent Belgium - epidemiology Biological and medical sciences Cadaver Child Child, Preschool Female Graft Rejection - epidemiology Humans Incidence Infant Liver Failure - mortality Liver Failure - surgery Liver Transplantation - mortality Liver Transplantation - statistics & numerical data Liver, biliary tract, pancreas, portal circulation, spleen Living Donors - statistics & numerical data Male Medical sciences Patient Selection Postoperative Complications - epidemiology Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Rate Treatment Outcome Belgium AR CyA-ME LR OLT Cad Tac PTLD CyA HLA Human Postoperative Iatrogenic Liver Mortality Living donor Related donor Transplantation Recipient Homotransplantation Survival Surgery Primary Complication Preoperative Child Cadaver
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Summary:	Study design: Between July 1993 and March 1997, 110 children were listed for primary elective liver transplantation with cadaveric (Cad: n = 68) or living-related (LR: n = 42) donors. Pregraft mortality, post-transplant survival, and surgical and immunologic complications were retrospectively compared in both groups. Results: The pregraft mortality rate was 10 (15%) of 68 versus 1 (2%) of 42 in the Cad and LR groups, respectively ( P = .049). Postliver transplantation 1-year patient and graft survival rates were 87% and 75% in the Cad group (n = 49) versus 92% and 90% in the LR group (n = 41), respectively (NS). The incidence of post-transplant complications was as follows: hepatic artery thrombosis (Cad: 16%; LR: 0%, P = .020), portal vein thrombosis (Cad: 8%; LR: 2%, NS), and biliary complications (Cad: 14%; LR: 34%, P = .044). The overall incidence of acute rejection was similar in both groups; however, a lower incidence of acute rejection occurred in LR graft recipients treated with tacrolimus. Conclusions: The introduction of an LR donor liver transplantation program allowed a significant decrease in the pretransplant mortality rate, with a consequent overall improvement in patient survival compared with the Cad series. The incidence of biliary complications was higher in the LR series, whereas better human leukocyte antigen matching in this subgroup did not result in a lower rejection incidence. (J Pediatr 1999;134:280-6)
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-3476 1097-6833
DOI:	10.1016/S0022-3476(99)70450-6