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Liver transplantation in pediatric patients: twenty years of experience at the University of Wisconsin.

Publication ,  Journal Article
D'Alessandro, AM; Knechtle, SJ; Chin, LT; Fernandez, LA; Yagci, G; Leverson, G; Kalayoglu, M
Published in: Pediatr Transplant
September 2007

Developments in surgical technique, immunosuppression, organ procurement and preservation, and patient selection criteria have resulted in improved long-term patient and graft survival after pediatric liver transplantation. In this study, we examined the results of 196 liver transplants performed in 155 pediatric patients at University of Wisconsin Children's Hospital. Patients were divided into two groups according to age at the time of liver transplant. Infants under 12 months of age comprised Group 1 (n=74) and children from one to 18 yr comprised Group 2 (n=122). Outcomes for whole, reduced-size, and split liver transplantation were compared in infants and children. Biliary atresia was the most common indication in both groups. Patients underwent 128 whole size, 50 reduced size, and 18 split liver transplants. Forty-one retransplantations were performed in 14 infants (18.9%) and in 27 children (22.1%). One hundred eleven patients (56.6%) had one or more rejection episode [37 infants (50.0%) and 74 children (60.6%)]. Thirty-nine patients (19.8%) developed CMV infections, 42 (21.4%) developed EBV infections, and 14 developed PTLD (six infants and eight children). Thirty-six patients (18.3%) developed HAT. Seven patients (4.5%) developed malignancy (one infant and six children). Out of 155 patients, 33 (21.3%) died during the study period. The most common etiology of mortality included central nervous system pathology (n=7; 4.5%), sepsis (n=6; 3.8%), and cardiac causes (n=6; 3.8%). One-, five-, and 10-yr actuarial patient survival was 86, 79, and 74% in infants and 90, 83 and 80% in children. Graft survival at one, five, and 10 yr was 77, 73 and 71% in infants and 88, 81 and 78% in children, respectively. Despite its technical challenges, the outcomes of liver transplantation in pediatric patients with end-stage liver disease are excellent and result in significant long-term patient and graft survival.

Duke Scholars

Published In

Pediatr Transplant

DOI

ISSN

1397-3142

Publication Date

September 2007

Volume

11

Issue

6

Start / End Page

661 / 670

Location

Denmark

Related Subject Headings

  • Wisconsin
  • Treatment Outcome
  • Time Factors
  • Survival Rate
  • Surgery
  • Liver Transplantation
  • Infant
  • Humans
  • Hospitals, University
  • Graft Survival
 

Citation

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D’Alessandro, A. M., Knechtle, S. J., Chin, L. T., Fernandez, L. A., Yagci, G., Leverson, G., & Kalayoglu, M. (2007). Liver transplantation in pediatric patients: twenty years of experience at the University of Wisconsin. Pediatr Transplant, 11(6), 661–670. https://doi.org/10.1111/j.1399-3046.2007.00737.x
D’Alessandro, A. M., S. J. Knechtle, L Thomas Chin, L. A. Fernandez, G. Yagci, G. Leverson, and M. Kalayoglu. “Liver transplantation in pediatric patients: twenty years of experience at the University of Wisconsin.Pediatr Transplant 11, no. 6 (September 2007): 661–70. https://doi.org/10.1111/j.1399-3046.2007.00737.x.
D’Alessandro AM, Knechtle SJ, Chin LT, Fernandez LA, Yagci G, Leverson G, et al. Liver transplantation in pediatric patients: twenty years of experience at the University of Wisconsin. Pediatr Transplant. 2007 Sep;11(6):661–70.
D’Alessandro, A. M., et al. “Liver transplantation in pediatric patients: twenty years of experience at the University of Wisconsin.Pediatr Transplant, vol. 11, no. 6, Sept. 2007, pp. 661–70. Pubmed, doi:10.1111/j.1399-3046.2007.00737.x.
D’Alessandro AM, Knechtle SJ, Chin LT, Fernandez LA, Yagci G, Leverson G, Kalayoglu M. Liver transplantation in pediatric patients: twenty years of experience at the University of Wisconsin. Pediatr Transplant. 2007 Sep;11(6):661–670.
Journal cover image

Published In

Pediatr Transplant

DOI

ISSN

1397-3142

Publication Date

September 2007

Volume

11

Issue

6

Start / End Page

661 / 670

Location

Denmark

Related Subject Headings

  • Wisconsin
  • Treatment Outcome
  • Time Factors
  • Survival Rate
  • Surgery
  • Liver Transplantation
  • Infant
  • Humans
  • Hospitals, University
  • Graft Survival