Outcome of pediatric-to-adult liver transplantation:a single-center study in China.
10.3760/cma.j.cn112139-20211216-00605
- VernacularTitle:儿童供肝在成人肝移植中应用的单中心研究
- Author:
Hao YU
1
;
Zhi Wei LI
2
;
Rong Rong WANG
3
;
Wei ZHANG
2
;
Xue Li BAI
1
;
Ting Bo LIANG
1
Author Information
1. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital,Zhejiang University School of Medicine, Hangzhou 310003, China.
2. Liver Transplant Center, the First Affiliated Hospital, Zhejing University School of Medicine, Hangzhou 310003, China.
3. Department of Clinical Pharmacy, the First Affiliated Hosppital, Zhejiang University School of Medicine, Hangzhou 310003, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Aged;
Blood Group Antigens;
Brain Death;
Child;
Child, Preschool;
Death;
Female;
Gastrointestinal Hemorrhage;
Humans;
Infant;
Liver Transplantation/adverse effects*;
Living Donors;
Male;
Middle Aged;
Retrospective Studies;
Treatment Outcome;
Venous Thrombosis
- From:
Chinese Journal of Surgery
2022;60(10):915-921
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the outcome of the pediatric-to-adult liver transplantation, including postoperative complications and relevant factors which affecting graft survival. Methods: Data of 55 patients undergoing pediatric-to-adult liver transplantation at the First Affiliated Hospital of Zhejiang University between January 2015 and August 2021 were retrospectively analyzed. The donors consisted of 34 males and 21 females, and the age was (11.8±4.7) years (range: 1 to 17 years). Among the cases,17 cases (30.9%) were donation of brain death,32 cases (58.2%) were donation of cardiac death, and 6 cases (10.9%) were donation after brain death plus cardiac death. The recipients consisted of 32 males and 23 females, and the age was (51.6±10.1) years (range: 27 to 70 years). Among the recipients,10 cases (18.2%) were ABO-incompatible liver transplantation.The influencing factors of early graft survival were analyzed by Student t test,Mann-Whitney U test or χ2 test,respectively.Survival curve was drawn by Kaplan-Meier method.Logistic multivariate analysis was used to analyze the independent relevant factors of early postoperative graft loss. Results: Up to October 31,2021,the follow-up time (M(IQR)) was 36.0(43.1)months(range:5.9 to 81.7 months).There were 13 cases with graft loss (two of them underwent re-transplantation due to acute liver failure).The monofactor analysis indicated that cold ischemia time and donor-recipient blood group matching were the relevant factors affecting the early graft survival rate(both P<0.05).Logistic multivariate analysis showed that cold ischemia time and history of recipient gastrointestinal bleeding were independent relevant factors(both P<0.05).Postoperative hepatic artery thrombosis occurred in 3 cases(5.5%), portal vein thrombosis diagnosed in 4 cases(7.3%), portal vein stenosis occurred in 2 cases(3.6%),biliary complications diagnosed in 7 cases(12.7%), and small liver syndrome was found in 8 cases(14.5%). Conclusions: Adult liver transplantation with pediatric donor liver is an effective method to treat end-stage liver disease.Cold ischemia time and history of recipient gastrointestinal bleeding were independent relevant factors for the early graft survival.
