Donor profile has significant impact on survival in pediatric liver transplantations
More information is needed into donor-specific risk factors of pediatric liver transplant, with an emphasis on infectious history, according to a presentation at the 6th World Congress of Paediatric Gastroenterology, Hepatology and Nutrition.
In this single-center, retrospective cohort study, data from 828 liver transplantations performed on 676 patients were analyzed to determine risk factors.
The 5-year patient survival improved significantly compared in recent years compared to the years 1983-1992 (97.5% vs 64%).
Infectious complications cause 45.2% of deaths. Cerebral events (14.4%), malignancies (9.4%), cardiopulmonal (7.2%), and graft-related complications (5.8%) were the other main causes of death.
Age between 12 and 18 years was a risk factor for mortality and patients with acute liver failure and viral hepatitis had higher mortality. Patients with biliary atresia, progressive familial intrahepatic cholestasis, and urea cycle disorders had improved outcomes. Mortality was increased with re-transplantation.
Bilirubine level and lower albumin at transplantation were risk factors, and prolonged cold ischaemic time, transplantation duration, and arterial thrombosis of the graft impaired survival.
For donors, creatinine elevation and positive CMV-IgM had a negative impact, whereas positive CMV-IgG improved survival. Half of the patients who transplanted from a CMV-IgM-positive donor died, with infectious complications the cause in 7.
Leiskau C, et al. Recipient and donor specific risk factors for mortality after paediatric liver transplantation. Presented at: 6th World Congress of Paediatric Gastroenterology, Hepatology and Nutrition