Experience of a successful pediatric liver transplant program in Mexico

Autor: Jose Manuel Tovilla-Mercado, R. Caltenco-Serrano, Roberto Dávila-Pérez, M.A. Abarca-Garcı́a, Gustavo Varela-Fascinetto, Eduardo Bracho-Blanchet, H. Palafox-Vázquez, V. Fuentes-Garcia, Pablo Lezama-del-Valle, Jaime Nieto-Zermeño, V. Olivar-López, P. Valencia-Mayoral, J.A. Hernández-Plata, PD Castañeda-Martínez
Rok vydání: 2005
Předmět:
Zdroj: Transplantation proceedings. 37(2)
ISSN: 0041-1345
Popis: Orthotopic liver transplantation (OLT) has been very difficult to develop in Mexico and for many years its occurrence was anecdotal. This report presents the results of a pediatric liver transplant program, analyzing the variables that affect outcomes. Between June 1998 and March 2004, 35 OLT were performed in 34 recipients including 80% cadaveric whole-organ grafts and 20% segmental grafts, with 11% from cadaveric and 9% from living donors. Most of the recipients were infants or toddlers weighing less than 15 kg. There was only 1 case of arterial thrombosis (2.8%); the graft was saved with a Kasai procedure. Biliary complications were present in 22% of cases, all resolved with reoperations. Posttransplant cytomegalovirus infection or reactivation (28%), acute rejection (25%), or posttransplant lymphoproliferative disorders (5.7%) were not a cause of graft or patient loss. Overall, 1- and 5-year patient survival rates are 77.1% and 74.2%, respectively; however, when the 1998-2000 cohort was compared with the 2001-2004 cohort, there was a significant difference in survival (P = .004). The 1-year patient survival for the later group is 91.6%. We performed the first successful living donor liver transplantation and the first simultaneous liver-kidney transplantation in a child in our country. Our results demonstrate that pediatric liver transplantation is a feasible undertaking in Mexico, with survival rates comparable to those of foreign centers.
Databáze: OpenAIRE
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