Biomaterial Database

Pediatric liver transplantation: a 3-year experience. 1989

W S Andrews, and E Wanek, and B Fyock, and S Gray, and M Benser

Department of Pediatric Surgery, UT Southwestern Medical Center, Dallas.

From September 1, 1984 to March 1, 1988, 201 patients were evaluated for liver transplantation. Ninety-one orthotopic liver transplants were performed on 80 children ranging in age from 3 months to 15 years. The average waiting time for a transplant was 5 months, with children less than 10 kg in weight waiting a disproportionately long time. The average operative time was 10.6 hours and the average blood product replacement was 2.7 blood volumes. There was a steady improvement in both operative time and blood loss from 1985 to 1987. The overall hepatic arterial thrombosis rate was 9%; complex reconstructions having a thrombosis rate of 39%, and end-to-end anastomoses having a thrombosis rate of 1.4%. The average hospital stay was 37 days, and the major causes of postoperative morbidity and mortality were rejection (75%), infection (50%), and diarrhea (76%). The 1- and 3-year survival rates were 75% and 73%, respectively. Children with a successful transplant returned to home and school. After transplantation, 60% of the children exhibited catch-up growth and 88% have normal liver function. Pediatric liver transplantation is an effective modality in the treatment of children with terminal liver disease. Increased pediatric organ donation and the investigation of new operative techniques and types of preservation are necessary to meet the needs of an expanding recipient pool.

UI	MeSH Term	Description	Entries
D007165	Immunosuppression Therapy	Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs.	Antirejection Therapy,Immunosuppression,Immunosuppressive Therapy,Anti-Rejection Therapy,Therapy, Anti-Rejection,Therapy, Antirejection,Anti Rejection Therapy,Anti-Rejection Therapies,Antirejection Therapies,Immunosuppression Therapies,Immunosuppressions,Immunosuppressive Therapies,Therapies, Immunosuppression,Therapies, Immunosuppressive,Therapy, Immunosuppression,Therapy, Immunosuppressive
D007223	Infant	A child between 1 and 23 months of age.	Infants
D008107	Liver Diseases	Pathological processes of the LIVER.	Liver Dysfunction,Disease, Liver,Diseases, Liver,Dysfunction, Liver,Dysfunctions, Liver,Liver Disease,Liver Dysfunctions
D008297	Male		Males
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D005260	Female		Females
D005500	Follow-Up Studies	Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.	Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006084	Graft Rejection	An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient.	Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections