Living Related Donor Liver Transplantation in Children: Indication and Clinical Outcome.
- Author:
Kyung Mo KIM
1
;
Sung Gyu LEE
;
Young Joo LEE
;
Kwang Min PARK
;
Seong Chul KIM
;
Hoon Bae CHUN
;
Eun Sil YOO
;
Kyung Suk KO
;
Sang Hoon HAN
;
Moon Gyu LEE
;
Kyu Taek CHOI
;
Jae Kon KO
;
Hyung Nam MOON
Author Information
1. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Liver transplantation;
Living donors;
Child;
Complications;
Survivial rates
- MeSH:
Bile Ducts;
Bile Ducts, Intrahepatic;
Biliary Atresia;
Blood Group Incompatibility;
Body Weight;
Child*;
Chungcheongnam-do;
Constriction, Pathologic;
Cyclosporine;
Fathers;
Fibrosis;
Hemorrhage;
Hepatitis;
Hepatolenticular Degeneration;
Humans;
Immunosuppression;
Liver Diseases;
Liver Transplantation*;
Liver*;
Living Donors;
Respiratory Distress Syndrome, Adult;
Respiratory Syncytial Viruses;
Survival Rate;
Tacrolimus;
Tissue Donors*;
Transplants
- From:Journal of the Korean Pediatric Society
1998;41(5):622-632
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Living related donor liver transplantation (LRLT) was introduced into our pediatric liver transplantation program as a response to the shortage of donors. This study was performed to evaluate the indication, complication and outcome of LRLT in children. METHODS: From December, 1994 to May, 1997, a total of 20 LRLTs had been performed at Asan Medical Center for end-stage liver disease. The patients ranged in age from 6 months to 14 years (median : 1 year 4 months) and in body weight from 5.8 to 50.5kg (median : 9.8kg). The indications for transplantation were biliary atresia (11), Wilson disease (3), nonsyndromic intrahepatic bile duct paucity (2), Byler syndrome (1), cirrhosis (1), fulminant hepatitis (1) and posthepatectomy bile duct stricture (1). Among them 3 ABO blood group incompatibilities were included. The lateral segment or the left lobe of the liver was used for the graft. As for immunosuppression, cyclosporin A based immunosuppression was used for the initial 11 cases which later changed into FK506 based for the last 9 cases. RESULTS: The actuarial survival rate of recipients was 90% for our cases. Two deaths occurred, one of whom died of acute respiratory distress syndrome due to respiratory syncytial virus infection on 51st postoperative day and the other died of gastrointestinal bleeding from Epstein- Barr virus infection and posttransplant lymphoproliferative disease on 11th postoperative month. No patient died of surgical complications. Acute rejection episodes were observed in 6 (5 among 11 cyclosporin A based immunosuppression and 1 among FK506 group) which were managed successfully. All donors (6 fathers and 14 mothers) are alive and well with normal activity. CONCLUSION: We concluded that LRLT is a promising option for alleviating the shortage of livers for pediatric transplantation.
