Retransplantation of the liver in children
| Autor: | JH Zwaveling, Robert J. Porte, Mjh Slooff, EM TenVergert, Pmjg Peeters, KP de Jong, Cma Bijleveld, Egbert Sieders |
|---|---|
| Přispěvatelé: | Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Jazyk: | angličtina |
| Rok vydání: | 2001 |
| Předmět: |
Reoperation
medicine.medical_specialty ORGANS DONOR LIVER medicine.medical_treatment Liver transplantation TRANSPLANT RECIPIENTS HEPATIC RETRANSPLANTATION MORBIDITY Biliary atresia Risk Factors Medicine Humans Risk factor Child Survival rate Cause of death Transplantation business.industry Graft Survival Infant medicine.disease Surgery Liver Transplantation Survival Rate Treatment Outcome SIZE Child Preschool Etiology RISK-FACTORS SURVIVAL EXPERIENCE GRAFTS business Complication |
| Zdroj: | Transplantation, 71(1), 90-95. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 0041-1337 |
| Popis: | Background Because of the poor outcome of hepatic retransplantation, it is still debated whether this procedure should be performed in an era of donor organ scarcity. The aim of this study was to analyze outcome of hepatic retransplantation in children, to identify risk factors influencing this outcome, and to assess morbidity and causes of death, Methods. A series of 97 children after a single trans plantation and 34 children with one retransplantation was analyzed. Results. The 1-, 3-, and 5-year survival of children with a retransplantation was 70, 63, and 52%, respectively, compared with 85, 82, and 78%, respectively, for children after a single transplantation (P=0.009), Survival of children with a retransplantation within 1 month after primary transplantation was worse (P=0.007) and survival of children with a late retransplantation was comparable (P=0.66) with single transplantation. In early retransplantations, the Child-Pugh score was higher, do nors were older and weighed more, and more technical variant Liver grafts were used compared with single transplantations. Biliary atresia and a high Child-Pugh score were associated with decreased patient survival after retransplantation. Sepsis was the most important complication and cause of death after retransplantation. Conclusions. Retransplantation is a significant event after pediatric liver transplantation. Outcome after hepatic retransplantation in children is inferior compared with single transplantation. This difference is explained by low survival after early retransplantation and can be explained by the poor clinical condition of the children at time of retransplantation, especially in children with biliary atresia, and by the predominant use of technical variant liver grafts in retransplantations. |
| Databáze: | OpenAIRE |
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