Living Donor Liver Transplantation in Children With Cholestatic Liver Disease: A Single-Center Experience

Abstract Objectives Cholestatic liver disease (CLD) is the main indication for liver transplantation in children. This retrospective study evaluated the outcomes of living donor liver transplantation (LDLT) in children with CLD. Methods One hundred fifty-nine children with CLD who underwent 164 LDLT...

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Bibliographic Details
Published in:Transplantation proceedings 2012-03, Vol.44 (2), p.469-472
Main Authors: Mizuta, K, Urahashi, T, Ihara, Y, Sanada, Y, Wakiya, T, Yamada, N, Okada, N, Egami, S, Hishikawa, S, Hyodo, M, Sakuma, Y, Fujiwara, T, Kawarasaki, H, Yasuda, Y
Format: Article
Language:English
Subjects:
Age Factors
Alagille Syndrome - mortality
Alagille Syndrome - surgery
Biliary Atresia - mortality
Biliary Atresia - surgery
Biological and medical sciences
Child
Child, Preschool
Cholangitis, Sclerosing - mortality
Cholangitis, Sclerosing - surgery
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
General aspects
Graft Rejection - etiology
Graft Rejection - surgery
Hepatectomy - adverse effects
Hepatectomy - mortality
Hospital Mortality
Humans
Infant
Infant, Newborn
Japan
Kaplan-Meier Estimate
Liver Transplantation - adverse effects
Liver Transplantation - mortality
Liver, biliary tract, pancreas, portal circulation, spleen
Living Donors
Male
Medical sciences
Postoperative Complications - etiology
Postoperative Complications - surgery
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Time Factors
Tissue, organ and graft immunology
Treatment Outcome
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Summary:Abstract Objectives Cholestatic liver disease (CLD) is the main indication for liver transplantation in children. This retrospective study evaluated the outcomes of living donor liver transplantation (LDLT) in children with CLD. Methods One hundred fifty-nine children with CLD who underwent 164 LDLT between May 2001 and May 2011 were evaluated. Their original diseases were biliary atresia ( n = 145, 91%), Alagille syndrome ( n = 8, 5%), primary sclerosing cholangitis ( n = 2), and the others ( n = 4). The mean age and body weight of the recipients at LDLT was 42 ± 53 months and 14.0 ± 11.0 kg, respectively. Results Parents were living donors in 98%. The left lateral segment was the most common type of graft (77%). There were no reoperations and no mortality in any living donor. Recipients' postoperative surgical complications consisted mainly of hepatic arterial problems (7%), hepatic vein stenosis (5%), portal vein stenosis (13%), biliary stricture (18%), intestinal perforation (3%). The overall rejection rate was 31%. Cytomegalovirus infection and Epstein-Barr virus disease were observed in 26% and 5%, respectively. Retransplantation was performed five times in four patients; the main cause was hepatic vein stenosis ( n = 3). Four patients died; the main cause was gastrointestinal perforation ( n = 2). The body height of Alagille syndrome patients less than 2 years old significantly improved compared with older patients after LDLT. The 1-, 5-, and 10-year patient survival rates were 98%, 97%, and 97%, respectively. Conclusions LDLT for CLD is an effective treatment with excellent long-term outcomes.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2011.11.014