Four hundred thirty consecutive pediatric living donor liver transplants: Variables associated with posttransplant patient and graft survival

The availability of living donors allows transplant teams to indicate living donor liver transplantation (LDLT) early in the course of liver disease before the occurrence of life‐threatening complications. Late referral to transplant centers is still a problem and can compromise the success of the p...

Full description

Saved in:

Bibliographic Details
Published in:	Liver transplantation Vol. 18; no. 5; pp. 577 - 584
Main Authors:	Neto, Joao Seda, Pugliese, Renata, Fonseca, Eduardo A., Vincenzi, Rodrigo, Pugliese, Vincenzo, Candido, Helry, Stein, Alberto B., Benavides, Marcel, Ketzer, Bernardo, Teng, Hsiang, Porta, Gilda, Miura, Irene K., Baggio, Vera, Guimaraes, Teresa, Porta, Adriana, Rodrigues, Celso Arrais, Carnevale, Francisco C., Carone, Eduardo, Kondo, Mario, Chapchap, Paulo
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-05-2012
Subjects:	Adolescent Adult Body Weight Female Graft Survival Hepatic Artery Humans Liver Transplantation - adverse effects Liver Transplantation - mortality Living Donors Male Middle Aged Multivariate Analysis Portal Vein Thrombosis - mortality Venous Thrombosis - mortality
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	The availability of living donors allows transplant teams to indicate living donor liver transplantation (LDLT) early in the course of liver disease before the occurrence of life‐threatening complications. Late referral to transplant centers is still a problem and can compromise the success of the procedure. The aim of this study was to examine the perioperative factors associated with patient and graft survival for 430 consecutive pediatric LDLT procedures at Sirio‐Libanes Hospital/A. C. Camargo Hospital (São Paulo, Brazil) between October 1995 and April 2011. The studied pretransplant variables included the following: recipient age and body weight, Pediatric End‐Stage Liver Disease score, z score for height/age, bilirubin, albumin, international normalized ratio, hemoglobin, sodium, presence of ascites, and previous surgery. The analyzed technical aspects included the graft‐to‐recipient weight ratio and the use of vascular grafts for portal vein reconstruction. In addition, the occurrence of hepatic artery thrombosis (HAT), portal vein thrombosis (PVT), and biliary complications was also analyzed. The liver grafts included 348 left lateral segments, 5 monosegments, 51 left lobes, and 9 right lobes. In a univariate analysis, an age < 12 months, a low body weight (≤10 kg), malnutrition, hyperbilirubinemia, and HAT were associated with decreased patient and graft survival after LDLT. In a multivariate analysis, a body weight ≤ 10 kg and HAT were significantly associated with decreased patient and graft survival. The use of vascular grafts significantly increased the occurrence of PVT. In conclusion, a low body weight (≤10 kg) and the occurrence of HAT independently determined worse patient and graft survival in this large cohort of pediatric LDLT patients. Liver Transpl, 2012. © 2012 AASLD.
Bibliography:	Telephone: 55‐11‐32310800; FAX: 55‐11‐32310900 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1527-6465 1527-6473
DOI:	10.1002/lt.23393