| Autor: |
T. Shisler, Jeffrey H. Fair, Glenn A. Halff, Kathy Orban-Eller, J. Mayo, Frederick M. Karrer, Cindy Mack, Susan Gilmour, A. Santiago, Ajai Khanna, J. Kraus, E. Phillips, C. Viau, Katie Neighbors, Leslie L. Studenski, Jean Pearson, Jody A. Weckwerth, L. Ferrer, Linda S. Book, Michelle Nadler, M. Christoff, Michelle Felix, M. K. Alford, W. Berquest, Louise Flynn, A. Bula, Jean Greseth, S. Fiest, L. Krawczuk, Fred Ryckman, John A. Goss, Munci Kalayoglu, Valorie Buchholz, Ross W. Shepherd, J. Eshun, K. Maseda, Dev M. Desai, Benjamin L. Shneider, George V. Mazariegos, Kathleen B. Schwarz, Tomoaki Kato, Joel E. Lavine, B. Dodd, J M Millis, Saul J. Karpen, Marcia Hodik, Douglas S. Fishman, C. Mark, John C. Bucuvalas, Deborah K. Freese, James D. Eason, D. Garner, Cynthia K. Kawai, Andre Hawkins, Peter L. Abt, Steven J. Lobritto, E. Spaith, Alan Norman Langnas, Debra L. Sudan, Humberto Soriano, Dean L. Antonson, Thomas G. Heffron, Robert Kane, M. Akyeampong, Vicky L. Ng, Elizabeth B. Rand, A. Fecteau, John C. Magee, Sukru Emre, K. Anderer, S. Wallace, Vicki Fioravanti, Robert Jurao, Nanda Kerkar, Molly O'Gorman, Stuart J. Knechtle, Andreas G. Tzakis, Deborah Weppler, Estella M. Alonso, Joseph Tector, Nissa I Erickson, Nydia Chien, Simon Horslen, Maureen M. Jonas, J. Prinzhorn, Melissa Young, J. DePaolo, Regino P. Gonzalez-Peralta, D. Filipowski, G. Arya, Ronald J. Sokol, Andreanne Benidir, S. V. McDiarmid, Norman M. Kneteman, Patricia Harren, P. Atkinson, L. Cutright, Robert A. Fisher, Thomas A. Aloia, Beth A. Carter, Alan W. Hemming, S. Lerrett, Pamela Boone, Beverly Fleckten, Jay S. Roden, J. Menendez, Jean F. Botha, James Lopez, J. Michael Millis, Angelo D'Alessandro, V. Shieck, Todd Pillen, Christine A. O'Mahony, Ravinder Anand, S. L. Powell, Jean P. Molleston, S. Cuellar, Fernando Alvarez, Jeffrey A. Lowell, Paul M. Colombani, Abhi Humar, Grzegorz Telega, M. de Angelis, Joan Lokar, James F. Daniel, S. McCracken, Kathleen Falkenstein, Ivan Diamond, Julian E. Losanoff, Michael R. Narkewicz, Lynn Seward, Naveen K. Mittal, J. Lim, Kenneth A. Andreoni, A. Tendick, Deborah A. Andersen, L. Cooper, P. Rosenthal, M. Castillo, Wendy J. Grant, R. Judo, Samuel So, Annie Fecteau, V. Ng, Stephen P. Dunn, Brenda Durand, Walter S. Andrews, Steven N. Lichtman, R. Clawson, L. Bruschke, L. Young, V. McLin, K.R. Seipel, L. Smith, Changhong Song, M. Gonzalez, Susan Kelly, L. Davis, Steven R. Martin, S. Jarvis |
| Rok vydání: |
2007 |
| Předmět: |
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| Zdroj: |
Annals of Surgery. 246:301-310 |
| ISSN: |
0003-4932 |
| Popis: |
To examine the outcome of technical variant liver transplant techniques relative to whole organ liver transplantation in pediatric liver transplant recipients.Technical variant liver transplant techniques comprising split, reduced, and live-donor liver transplantation evolved to address the need for timely and size appropriate grafts for pediatric recipients.Analysis of data from the Studies of Pediatric Liver Transplantation (SPLIT) registry, a multicenter database of 44 North American pediatric liver transplant programs. The outcome (morbidity and mortality) of each of the technical variants were compared with that of whole organ recipients.Data were available on 2192 transplant recipients (1183 whole, 261 split, 388 reduced, and 360 live donor). Recipients of all technical variant graft type were significantly younger than whole organ recipients, but on average spent 2.3 months less on the waiting list. Thirty-day post-transplant morbidity was increased for each type of technical variant relative to whole organ (45.1% whole, 66.7% split, 65.5% reduced, 51.9% live-donor). Biliary complications (30 day: 7.5% whole, 18.8% split, 16% reduced, 17.5% live-donor) and portal vein thrombosis (30 day: 3.6% whole, 8% split, 8% reduced, 7.5% live-donor) were more common in all technical variant types. Graft type was an independent predictor of graft loss (death or retransplantation) in a multivariate analysis. Split and reduced (relative risk = 1.74 and 1.77, respectively) grafts had a worse outcome when compared with whole organ recipients.Technical variant techniques expand the pediatric donor pool and reduce time from listing to transplant, but they are associated with increased morbidity and mortality. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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