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Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e3182a80362
Original Articles: Hepatology and Nutrition

Improved Outcomes in Liver Transplantation in Children With Acute Liver Failure

Oh, Seak Hee*; Kim, Kyung Mo*; Kim, Dae Yeon; Kim, Young*; Song, Seung Min*; Lee, Yeoun Joo*; Park, Seong-Jong*; Yoon, Chong Hyun; Ko, Gi-Young§; Sung, Kyu-Bo§; Hwang, Gyu-Sam||; Choi, Kyu-Taek||; Yu, Eunsil; Song, Gi-Won#; Ha, Tae-Yong#; Moon, Deok-Bog#; Ahn, Chul-Soo#; Kim, Ki-Hun#; Hwang, Shin#; Park, Kwang-Min**; Lee, Young-Joo**; Lee, Sung-Gyu#

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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.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,


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