Comparative study between living and cadaveric donors in pediatric liver transplantation

被引:12
|
作者
Oliveros, FH
Santamaría, ML
Gámez, MG
Murcia, J
Leal, N
Frauca, E
Hierro, L
Camarena, C
de la Vega, A
Bortolo, G
Díaz, MC
Jara, P
机构
[1] Univ Madrid, Hosp La Paz, Dept Pediat Surg, Madrid 28046, Spain
[2] Univ Madrid, Hosp La Paz, Dept Hepatol, Madrid 28046, Spain
关键词
D O I
10.1016/j.transproceed.2005.10.072
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
We examined whether the results in living-related hepatic transplantation (LRLT) are better than those from a cadaveric donor (CDLT). Material and methods. The last 27 consecutive LRLT, performed from 1998 to 2005, were compared with 27 CDLT matched for age, weight, date, and diagnosis. Grafts in LRLT group were left lateral segment (n = 22), left lobe (n = 3), and right lobe (n = 2). In the CDLT group, the grafts were split in situ (n = 10), hepatic reduction (n = 9) and whole liver (n = 8). We analyzed the actuarial survivals (grafts and children), retransplantation, primary nonfunction, initial graft malfunction (liver enzymes > 2000 U/L), surgical complications, rejection, and resource consumption. Results. Patient survivals at 6 months, 1 year, and 5 years were 100%, 96%, and 96% in LRLT and 100%, 100%, and 100% in CDLT (P = NS). Graft survivals were 93%, 89%, and 89% versus 96%, 96%, and 96%, respectively (P = NS). Complications were biliary complications (LRLT, 25% vs CDLT, 3%; P = .021); portal vein thrombosis (LRLT, 7% vs CDLT, 3%; NS), and hepatic artery thrombosis (LRLT, 0% vs CDLT, 3%; NS). The overall incidence of acute rejection was slightly higher (NS) in LRLT (LRLT, 18% vs CDLT, 11%; NS). Liver enzyme levels were higher in the CDLT group, but initial malfunction rate was not statistically different. Regarding resource consumption: blood product needs were higher in LRLT (P < .05) and hospital stay and ICU stay were longer, although not significantly, among LRLT. Conclusions. The results in LRLT among children are similar to those obtained in CDLT. We found a trend towards less initial graft malfunction in LRLT. Blood product needs were higher in LRLT. Hospital and ICU stay were longer, but not significantly different in LRLT. The benefits of LRLT are saving a scarce resource: a cadaveric donor liver graft.
引用
收藏
页码:3936 / 3938
页数:3
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