Improved survival of pediatric deceased donor liver transplantation recipients after introduction of the pediatric prioritization system: Analysis of data from a Japanese national survey.

Autor: Takemura Y; Department of Surgery, Keio University School of Medicine, Tokyo, Japan., Shinoda M; Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan., Kasahara M; Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan., Sakamoto S; Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan., Hatano E; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Okamoto T; Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Ogura Y; Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Aichi, Japan., Sanada Y; Division of Gastroenterological, General and Transplant Surgery, Department of Surgery, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan., Matsuura T; Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Ueno T; Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan., Obara H; Department of Surgery, Keio University School of Medicine, Tokyo, Japan., Soejima Y; Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan., Umeshita K; Department of Surgery, Osaka International Cancer Institute, Chuo-ku, Osaka, Japan.; Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka, Japan., Eguchi S; Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan., Kitagawa Y; Department of Surgery, Keio University School of Medicine, Tokyo, Japan., Egawa H; Hamamatsu Rosai Hospital, Hamamatsu-shi, Shizuoka, Japan., Ohdan H; Department of Gastroenterological and Transplant Surgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima City, Hiroshima, Japan.
Jazyk: angličtina
Zdroj: Journal of hepato-biliary-pancreatic sciences [J Hepatobiliary Pancreat Sci] 2024 Nov; Vol. 31 (11), pp. 782-797. Date of Electronic Publication: 2024 Aug 19.
DOI: 10.1002/jhbp.12062
Abstrakt: Background: In Japan, there has never been a national analysis of pediatric deceased donor liver transplantation (pDDLT) based on donor and recipient factors. We constructed a Japanese nationwide database and assessed outcomes of pDDLT focusing on the pediatric prioritization system introduced in 2018.
Methods: We collected data on pDDLTs (<18 years) performed between 1999 and 2021 from the Japan Organ Transplant Network and Japanese Liver Transplantation Society, identified risk factors for graft survival and compared the characteristics and graft survival in pDDLTs conducted before and after the introduction of the pediatric prioritization system.
Results: Overall, 112 cases of pDDLT were included, with a 1-year graft survival rate of 86.6%. Four poor prognostic factors were identified: recipient intensive care unit stay, model for end-stage liver disease/pediatric end-stage liver disease score, donor cause of death, and donor total bilirubin. After the introduction of the system, allografts from pediatric donors were more reliably allocated to pediatric recipients and the annual number of pDDLTs increased. The 1-year graft survival rate improved significantly as did pDDLT conditions indicated by the risk factors.
Conclusions: Under the revised allocation system, opportunities for pDDLT increased, resulting in favorable recipient and donor conditions and improved survival.
(© 2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.)
Databáze: MEDLINE
Externí odkaz: