Ten years of a pediatric living donor liver transplantation program in Brazil.

Marco Aurélio Farina Junior, Melina Utz-Melere, Carolina Soares da Silva, Luiza Salgado Nader, Cristine Suzana Trein, Angelica Maria Lucchese, Mayara Machry, Rodrigo Mariano, Cristina Targa Ferreira, Antônio Nocchi Kalil, Flávia Heinz Feier
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Abstract

Background: Pediatric living-donor liver transplantation is considered a safe alternative for the treatment of children with end-stage liver disease. Experienced tertiary centers and specialized medical staff are necessary to ensure compatible long-term survival rates and quality-of-life for these children.

Aim: To report the results and the 10-year learning curve of a pediatric living-donor liver transplantation program.

Methods: We conducted a retrospective cohort study of pediatric recipients from 2013 to 2023. Post-transplant outcomes and patient survival rates were compared between two 5-year periods of the program.

Results: A total of 25 and 48 patients underwent transplantation in the first (2013-2017) and second period (2018-2023), respectively. Portal vein and hepatic artery thrombosis occurred in 11 (15.1%) and seven (9.6%) patients, respectively. Biliary complications were observed in 39 of 73 patients (53.4%). A lower warm ischemia time was observed in the second period compared to the first (32.6 ± 8.6 minutes vs 38.4 ± 9.8 minutes, P = 0.018, respectively). Patient survival rates at 1 and 5 years were 84% in the first period and 91.7% in the second period, with no significant difference (P = 0.32).

Conclusion: The reported indications and outcomes align with the current literature. Our findings provide crucial evidence regarding the feasibility of establishing a living donor program with consistent results over time.

十年的巴西儿童活体肝脏移植项目。
背景:儿童活体供肝移植被认为是治疗终末期肝病儿童的一种安全选择。经验丰富的三级医疗中心和专业医务人员是确保这些儿童长期生存率和生活质量的必要条件。目的:报道儿童活体肝移植项目的结果和10年学习曲线。方法:我们对2013年至2023年的儿科受体进行了回顾性队列研究。移植后的结果和患者存活率在两个5年的项目期间进行比较。结果:第一期(2013-2017年)和第二期(2018-2023年)分别有25例和48例患者接受了移植。门静脉血栓11例(15.1%),肝动脉血栓7例(9.6%)。73例患者中有39例(53.4%)出现胆道并发症。与第一期相比,第二期热缺血时间较短(32.6±8.6 min vs 38.4±9.8 min, P = 0.018)。第一期患者1年和5年生存率为84%,第二期为91.7%,差异无统计学意义(P = 0.32)。结论:报告的适应症和结果与当前文献一致。我们的研究结果为建立活体捐赠计划的可行性提供了关键证据,并随着时间的推移产生一致的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
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