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Graft loss after pediatric liver transplantation.
- Source :
-
Annals of surgery [Ann Surg] 2002 Jan; Vol. 235 (1), pp. 125-32. - Publication Year :
- 2002
-
Abstract
- Objective: To describe the epidemiology and causes of graft loss after pediatric liver transplantation and to identify risk factors.<br />Summary Background Data: Graft failure after transplantation remains an important problem. It results in patient death or retransplantation, resulting in lower survival rates.<br />Methods: A series of 157 transplantations in 120 children was analyzed. Graft loss was categorized as early (within 1 month) and late (after 1 month). Risk factors were identified by analyzing recipient, donor, and transplantation variables.<br />Results: Kaplan-Meier 1-month and 1-, 3-, and 5-year patient survival rates were 85%, 82%, 77%, and 71%, respectively. Graft survival rates were 71%, 64%, 59%, and 53%, respectively. Seventy-one of 157 grafts (45%) were lost: 18 (25%) by death of patients with functioning grafts and 53 (75%) by graft-related complications. Forty-five grafts (63%) were lost early after transplantation. Main causes of early loss were vascular complications, primary nonfunction, and patient death. Main cause of late graft loss was fibrosis/cirrhosis, mainly as a result of biliary complications or unknown causes. Child-Pugh score, anhepatic phase, and urgent transplantation were risk factors for early loss. Donor age, donor/recipient weight ratio, blood loss, and technical-variant liver grafts were risk factors for late loss.<br />Conclusions: To prevent graft loss after pediatric liver transplantation, potential recipients should be referred early so they can be transplanted in an earlier phase of their disease. Technical-variant liver grafts are risk factors for graft survival. The logistics of the operation need to be optimized to minimize the length of the anhepatic phase.
Details
- Language :
- English
- ISSN :
- 0003-4932
- Volume :
- 235
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 11753051
- Full Text :
- https://doi.org/10.1097/00000658-200201000-00016