Improved survival in children with HPS: Experience from two high volume liver transplant centers across continents.

Autor: Shanmugam N; Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India., Hakeem AR; Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India., Valamparampil JJ; Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India., Aldouri A; Paediatric Intensive Care Unit, King's College Hospital, London, UK., Bansal M; Paediatric Intensive Care Unit, King's College Hospital, London, UK., Reddy MS; Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India., Thiruchunapalli D; Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India., Vilca-Melendez H; Paediatric Liver Centre, King's College Hospital, London, UK., Baker A; Paediatric Liver Centre, King's College Hospital, London, UK., Dhawan A; Paediatric Liver Centre, King's College Hospital, London, UK., Heaton N; Paediatric Liver Centre, King's College Hospital, London, UK., Rela M; Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India., Deep A; Paediatric Intensive Care Unit, King's College Hospital, London, UK.
Jazyk: angličtina
Zdroj: Pediatric transplantation [Pediatr Transplant] 2021 Nov; Vol. 25 (7), pp. e14088. Date of Electronic Publication: 2021 Aug 05.
DOI: 10.1111/petr.14088
Abstrakt: Background: Severe HPS increases morbidity and mortality after LT in children. We reviewed the combined experience of LT for HPS in children from two LT centers in Europe and Asia.
Methods: All children with "proven" HPS as per ERS Task Force criteria (detailed in manuscript) who underwent LT were categorized into M (PaO 2 ≥80 mmHg), Mo (PaO 2  = 60-79 mmHg), S (50-59 mmHg), and VS (PaO 2 <50 mmHg) HPS, based on room air PaO 2 .
Results: Twenty-four children with HPS underwent 25 LT (one re-transplantation) at a median age of 8 years (IQR, 5-12), after a median duration of 8 (4-12) months following HPS diagnosis. Mechanical ventilation was required for a median of 3 (1.5-27) days after LT. Ten children had "S" post-operative hypoxemia, requiring iNO for a median of 5 (6-27) days. "VS" category patients had significantly prolonged invasive ventilation (median 35 vs. 3 and 1.5 days; p = .008), ICU stay (median 39 vs. 8 and 8 days; p = .007), and hospital stay (64 vs. 26.5 and 23 days; p < .001) when compared to "S" and "M/Mo" groups, respectively. The need for pre-transplant home oxygen therapy was the only factor predicting need for re-intubation. Patient and graft survival at 32 (17-98) months were 100% and 95.8%. All children ultimately had complete resolution of HPS.
Conclusions: VS HPS is associated with longer duration of mechanical ventilation and hospital stay, which emphasizes the need for early LT in these children.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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