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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 6  |  Page : 677-683

Outcomes of Liver Transplantation Using Pediatric Deceased Donor Livers: A Single-Center Analysis of 102 Donors


1 Liver Transplantation Center, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing 100050; Department of Hepatobiliary and Pancreatic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi 030012, China
2 Liver Transplantation Center, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Correspondence Address:
Prof. Zhi-Jun Zhu
Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing 100050
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.226901

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Background: The outcome of pediatric deceased donor liver transplantation (LT) has not been well studied, especially pediatric deceased donor livers used in adult transplantation. This study aimed to evaluate the efficacy of LT using pediatric deceased donor livers and compare the outcomes between pediatric-to-pediatric LT and pediatric-to-adult LT. Methods: A retrospective review of LT using pediatric deceased donor livers from June 2013 to August 2016 was performed. The patients were divided into the pediatric-to-pediatric LT group and pediatric-to-adult LT group based on the ages of the recipients. The survival and incidence of early vascular complications (VCs) were observed between the two groups. We also analyzed the risk factors of early VCs in pediatric LT and the effect of donor hypernatremia on the prognosis of recipients. Results: There were 102 cases of LT using pediatric deceased donor livers in our hospital from June 2013 to August 2016, 83 pediatric-to-pediatric LT (recipients' age ≤13 years) and 19 pediatric-to-adult LT (recipients' age ≥19 years). The ratio of early VC was similar in the two groups (19.3% vs. 10.6%, P = 0.514). Low body weight of recipient was an independent risk factor of early VC in pediatric LT (odds ratio: 0.856, 95% confidence interval: 0.752–0.975, P = 0.019). The 1-year cumulative survival rates of grafts and patients were 89.16% and 91.57% in pediatric-to-pediatric LT and 89.47% and 94.74% in pediatric-to-adult LT, respectively (all P > 0.05). In all cases, patients using donors with hypernatremia (serum sodium levels ≥150 mmol/L) had worse graft survival (χ2=4.330, P = 0.037). Conclusions: Pediatric-to-pediatric LT group has similar graft and patient survival rates with those of pediatric-to-adult LT group. Low body weight of recipients is an independent risk factor of early VC in pediatric LT. Patients using donors with hypernatremia have worse graft survival.

 

 Abstract in Chinese

儿童死亡器官捐献供肝肝移植:单中心102例供体分析

摘要

背景:儿童死亡器官捐献供肝肝移植的效果目前研究较少,特别是儿童供肝用于成人肝移植。本研究旨在评估使用儿童死亡器官捐献供肝肝移植的疗效,并比较儿童供肝用于儿童和成人的临床效果。

方法:对2013年6月至2016年8月期间我院使用儿童死亡器官捐献供肝的肝移植患者进行回顾性分析。根据接受者的年龄不同分为儿童-儿童肝移植组和儿童-成人肝移植组。观察两组早期血管并发症的生存率和生存率。分析儿童肝移植早期血管并发症发生的危险因素以及供体高钠血症对受者预后的影响。

结果:自2013年6月至2016年8月,我院共实施儿童死亡器官捐献供肝肝移植102例,其中儿童-儿童肝移植组83例(受者年龄≤13岁),儿童-成人肝移植组19例(受者年龄≥ 19岁)。两组早期血管并发症发生率相似(19.3% vs. 10.6%,P=0.514)。在儿童肝移植中,受体低体重是早期血管并发症发生的独立危险因素(OR: 0.856, 95% CI: 0.752-0.975, P = 0.019)。两组移植物及受者生存率差异无统计学意义(χ2=0.026, P=0.872 and χ2=0.204, P=0.652),儿童-儿童肝移植组移植物和受者的1年生存率为89.16%,91.57%,而儿童-成人肝移植组分别为89.47%,94.74% (均 为 P>0.05)。供者高钠血症会导致受者的移植物存活率降低(χ2=4.330, P = 0.037)。

结论:儿童死亡器官捐献供肝用于儿童和成人肝移植有相似的移植物和受者生存率。受体低体重是儿童肝移植早期血管并发症发生的独立危险因素。高钠血症供者可影响受者移植物的生存率。



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