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J Pediatr Surg. 2018 Aug;53(8):1516-1522. doi: 10.1016/j.jpedsurg.2018.04.029. Epub 2018 Apr 27.

The rate of hepatic artery complications is higher in pediatric liver transplant recipients with metabolic liver diseases than with biliary atresia.

Author information

1
Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
2
Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: gsleenj@hanmail.net.
3
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: hchang@snu.ac.kr.
4
Department of Surgery, Chonbuk National University College of Medicine, Jeonju, Republic of Korea.
5
Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
6
Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
7
Department of Plastic and Reconstructive Surgery, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.
8
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.

Abstract

BACKGROUND:

Liver transplantation (LT) is an excellent treatment option for patients with biliary atresia (BA) who fail portoenterostomy surgery. LT is also increasingly performed in patients with metabolic liver diseases. This study compared the outcomes in pediatric patients who underwent LT for metabolic liver diseases and BA.

BASIC PROCEDURES:

Data from 237 pediatric patients who underwent primary LT at Seoul National University Hospital from 1988 to 2015, including 33 with metabolic liver diseases and 135 with BA, were retrospectively analyzed.

MAIN FINDINGS:

Compared with children with BA, children with metabolic liver diseases were significantly older at the time of LT (121.3 vs. 37.3 months; P < 0.001), and had lower Child-Pugh (7.1 vs. 8.4; P = 0.010) and Pediatric End-stage Liver Disease (6.5 vs. 12.8; P = 0.042) scores. Overall survival rates were similar (87.8% vs. 90.8%; P = 0.402), but hepatic artery (HA) complications were significantly more frequent in children with metabolic liver diseases (12.1% vs. 1.5%; P = 0.014).

PRINCIPAL CONCLUSION:

Despite similar overall survival, children with metabolic liver diseases had a higher rate of HA complications.

TYPE OF SUBMISSION:

Original article, Case control study, Retrospective.

EVIDENCE LEVEL:

III.

KEYWORDS:

Biliary atresia; Metabolic liver disease; Pediatric liver transplantation

PMID:
29861326
DOI:
10.1016/j.jpedsurg.2018.04.029
[Indexed for MEDLINE]

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