Improved Outcomes in Liver Transplantation in Children With Acute Liver Failure
Seak Hee Oh
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Kyung Mo Kim
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Address correspondence and reprint requests to Kyung Mo Kim, MD, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 388-1 Pungnap-Dong, Songpa-Gu, Seoul 138-736, Korea (e-mail: [email protected]).Search for more papers by this authorDae Yeon Kim
Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorYoung Kim
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeung Min Song
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorYeoun Joo Lee
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeong-Jong Park
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChong Hyun Yoon
Department of Pediatric Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorGi-Young Ko
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKyu-Bo Sung
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorGyu-Sam Hwang
Department of Anesthesiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKyu-Taek Choi
Department of Anesthesiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorEunsil Yu
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorGi-Won Song
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorTae-Yong Ha
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorDeok-Bog Moon
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChul-Soo Ahn
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKi-Hun Kim
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorShin Hwang
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKwang-Min Park
Department of Surgery, Division of Hepato-Biliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorYoung-Joo Lee
Department of Surgery, Division of Hepato-Biliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSung-Gyu Lee
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeak Hee Oh
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorCorresponding Author
Kyung Mo Kim
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Address correspondence and reprint requests to Kyung Mo Kim, MD, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 388-1 Pungnap-Dong, Songpa-Gu, Seoul 138-736, Korea (e-mail: [email protected]).Search for more papers by this authorDae Yeon Kim
Department of Pediatric Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorYoung Kim
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeung Min Song
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorYeoun Joo Lee
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSeong-Jong Park
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChong Hyun Yoon
Department of Pediatric Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorGi-Young Ko
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKyu-Bo Sung
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorGyu-Sam Hwang
Department of Anesthesiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKyu-Taek Choi
Department of Anesthesiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorEunsil Yu
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorGi-Won Song
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorTae-Yong Ha
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorDeok-Bog Moon
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorChul-Soo Ahn
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKi-Hun Kim
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorShin Hwang
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorKwang-Min Park
Department of Surgery, Division of Hepato-Biliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorYoung-Joo Lee
Department of Surgery, Division of Hepato-Biliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorSung-Gyu Lee
Division of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Search for more papers by this authorThe authors report no conflicts of interest.
ABSTRACT
Objective:
The aim of our study was to review the experiences of a living donor–dominant transplantation program for children with acute liver failure (ALF).
Methods:
Data were derived from the retrospective chart review of 50 children with ALF in a major liver center in the Republic of Korea.
Results:
A total of 50 children with ALF underwent 47 (94%) primary living donor liver transplantations and 3 (6%) cadaveric liver transplantations. The cumulative survival rates of the grafts at 1 and 5 years were 81.9% and 79.2%, respectively. The overall retransplantation rate was 12%. The cumulative survival rates of these patients at 1 and 5 years were all 87.9%. Most incidents of mortality followed the failure of the preceding graft. We observed no mortalities among donors. Based on multivariate analysis, children who had pretransplant thrombocytopenia or had to use the molecular adsorbent recycling system preoperatively were related to the graft loss. Age younger than 2 years and a hyperacute onset (within 7 days) of hepatic encephalopathy were associated with pretransplant thrombocytopenia.
Conclusions:
Living donor–dominant transplantation program in the present study demonstrates tolerable achievements in terms of clinical outcomes of recipients and donors; however, putative factors, such as pretransplant thrombocytopenia, seem to play unclear roles in a poor prognosis following transplantation.
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