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 11 August 2022

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News

Excellent long-term survival in most pediatric primary liver graft recipients

The long-term outcome for pediatric primary liver graft recipients surviving the early postoperative period is excellent, except for patients with liver malignancy, claim researchers from Belgium and Germany.

News image

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The team assessed the long-term survival and late graft loss in pediatric liver transplant recipients, and published the findings in July's Liver Transplantation.

A total of 376 primary liver graft recipients, who survived more than 3 months after transplantation (81% of all primary graft recipients), were studied.

Patient records were reviewed retrospectively for causes of graft loss.

Analyzing graft, recipient, and post-transplant variables identified associated risk factors.

The 1-, 5-, and 10-year actuarial graft survival rates in the study population were 95%, 87%, and 86%, respectively.

Corresponding patient survival rates were 96%, 91%, and 90%.

Some 47 (12.5%) grafts were lost subsequently, 15 by patient death with preserved graft function.

Patient survival rates:
1-year: 96%
5-year: 91%
10-year: 90%
Liver Transplantation
The researchers found that the survival rate was 63% after late re-transplantation.

Causes of late graft loss were infection (21%), post-transplant lymphoproliferative disease (PTLD, 21%), chronic rejection (17%), biliary complications (15%), and recurrence of malignant disease (9%).

Independent risk factors for late graft loss and patient death included liver malignancy as primary disease, steroid resistant rejection, and PTLD.

Furthermore, it was found that graft loss rate was significantly increased for reduced-size grafts.

Patients undergoing transplantation after 1991 and recipients of full-size grafts were more likely to survive.

Dr Michael A. Wallot, of the University of Essen, said on behalf of his group, "The long-term outcome for pediatric primary liver graft recipients surviving the early postoperative period is excellent, except for patients with liver malignancy.

"There is no increased risk of late graft loss with the use of split or living related donor grafts."

"Technical complications are only a minor factor in late graft loss, but complications related to immunosuppression and infection remain a major hazard and must be addressed," he concluded.

Liver Transpl 2002; 8: 615-22
04 July 2002

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