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Orthotopic liver transplantation for acute hepatic failure in children.
- Source :
-
Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 1994; Vol. 7 Suppl 1, pp. S104-7. - Publication Year :
- 1994
-
Abstract
- Thirty children received 35 liver transplants for fulminant or late-onset liver failure between March 1988 and May 1993. Aetiology included non-A non-B hepatitis in 12, Wilson's disease in 8, drug-induced hepatic failure in 6, hepatitis B in 1, hepatitis A in 1, tyrosinaemia in 1 and congenital haemochromatosis in 1. Three patients were retransplanted, one each for hepatic artery thrombosis, non-A non-B graft reinfection, and chronic rejection. Two of these three patients received a third transplant for chronic rejection and hepatic artery thrombosis. One patient in the retransplant group survived. Overall, graft and patient survival at a mean follow-up of 17 months were 49% and 57%, respectively. Mortality was related to vascular complications in three patients (hepatic venous obstruction, portal vein thrombosis and hepatic artery thrombosis). Two patients died of primary sepsis (cerebral aspergillosis and cytomegalovirus (CMV) pneumonitis in association with graft-versus-host disease). Systemic sepsis and multiorgan failure was documented as a cause of death in four children and sepsis in association with chronic rejection in a further three patients. One child died of respiratory failure 4 weeks after transplantation. Mortality in eight children less than 2 years was 75% and this was significantly greater than for older children (P < 0.003, Mantel Cox). Earlier referral, even in the absence of a definitive diagnosis and particularly in children under 2 years is advisable and may improve survival.
- Subjects :
- Adolescent
Adult
Child
Follow-Up Studies
Graft Rejection surgery
Humans
Liver Failure, Acute etiology
Liver Transplantation mortality
Liver Transplantation physiology
Postoperative Complications
Reoperation
Retrospective Studies
Survival Rate
Time Factors
Graft Survival
Liver Failure, Acute surgery
Liver Transplantation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0934-0874
- Volume :
- 7 Suppl 1
- Database :
- MEDLINE
- Journal :
- Transplant international : official journal of the European Society for Organ Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 11271176
- Full Text :
- https://doi.org/10.1111/j.1432-2277.1994.tb01322.x