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Late Graft Loss or Death in Pediatric Liver Transplantation: An Analysis of the SPLIT Database

2007; Elsevier BV; Volume: 7; Issue: 9 Linguagem: Inglês

10.1111/j.1600-6143.2007.01893.x

1600-6143

Kyle Soltys, George Mazariegos, Robert H. Squires, Rakesh Sindhi, Ravinder Anand, Stephen P. Dunn, Jerome Manendez, Louise Flynn, Maureen M. Jonas, Laura E. Krawczuk, Marielle Christoff, Robert E. Kane, Harvey Solomon, E. A. Phillips, Laurie Ferrer, Thomas G. Heffron, J M DePaolo, T Pillen, L Davis, John C. Bucuvalas, Fred Ryckman, Andre Hawkins, Gajra Arya, Michael R. Narkewicz, Ronald J. Sokol, F Karrer, C. Vanderwel Mark, Kathy Orban-Eller, Abhi Humar, Brenda Durand, Leslie L. Studenski, Elizabeth B. Rand, Kathleen Anderer, George Mazariegos, Nydia Chien, Lynn Seward, Paul Atkison, Jay Roden, Naveen Mittal, Lisa Cutright, Grzegorz Telega, Stacee M. Lerret, Estelle M. Alonso, Joan Lokar, Susan Kelly, Katie Neighbors, Walter S. Andrews, James F. Daniel, V. Fioravanti, A. Tendick, Anne S. Lindblad, Ravinder Anand, Changhong Song, Karen Martz, Jeff Mitchell, Gladys Fraser, Nicole Hornbeak, Nirali Patel, Jianghang He, Annie Fecteau, Vicky L. Ng, Maria De Angelis, Andréanne Benidir, Kathleen B. Schwarz, Paul Colombani, May Kay Alford, Michelle Felix, Robert Jurao, James D. Eason, John Eshun, Sandra L. Powell, Deborah K. Freese, Jody Weckwerth, Jean Greseth, Lori Young, Robert A. Fisher, Michael Akyeampong, Samuel So, William E. Berquist, Marcia Castillo, Annalie Bula, Sukru Emre, Benjamin L. Shneider, Nanda Kerkar, Salvador Cuellar, Saul J. Karpen, Jaymee Mayo, John A. Goss, Douglas S. Fishman, Val McLin, Beth Carter, Christine A. O’Mahony, Thomas A. Aloia, Donna Garner, Susan Gilmour, Bernadette Dodd, Norman Kneteman, Sue V. McDiarmid, Susan Fiest, Steven J. Lobritto, Lesley J. Smith, Patricia Harren, Kristin Maseda, Fernando Álvarez, Steven R. Martin, C. Viau, Ross W. Shepherd, Jeffrey A. Lowell, Michelle Nadler, Joel E. Lavine, Ajai Khanna, R E Clawson, J. J. Bravo López, John Magee, Vicky Shieck, Jeffrey H. Fair, Steven N. Lichtman, Kenneth A. Andreoni, Joanne Prinzhorn, Valorie Buchholz, Simon Horslen, Melissa Young, Glenn A. Halff, Stacey Wallace, Joseph Tector, Joel Lim, Jean P. Molleston, J. E. G. Pearson, Humberto E. Soriano, Kathleen P. Falkenstein, Andreas Tzakis, Tomoaki Kato, Debbie Weppler, Lisa Cooper, Monica L. Gonzalez, Alma Dolores Pérez‐Santiago, Münci Kalayoğlu, Anthony M. D’Alessandro, Nissa Erickson, Robert Judo, Stuart J. Knechtle, E Spaith, Regino P. González‐Peralta, Marcia Hodik, Stacia McCracken, Philip Rosenthal, Danusia Filipowski, Linda Book, Molly O’Gorman, C Kawai, Lacey Bruschke, Jennifer Kraus, Alan N. Langnas, Dean L. Antonson, Jean Botha, Wendy Grant, Debra L. Sudan, Debb Andersen, Beverly Fleckten, K. Seipel, J. Michael Millis, Patricia Ann Boone, Dev M. Desai, Sherri Javis, Peter L. Abt, Tomi Shisler, Cindy Mack,

Renal Transplantation Outcomes and Treatments

Late graft loss (LGL) and late mortality (LM) following liver transplantation (LT) in children were analyzed from the studies of pediatric liver transplantation (SPLIT) database. Univariate and multivariate associations between pre‐ and postoperative factors and LGL and LM in 872 patients alive with their primary allografts 1 year after LT were reviewed. Thirty‐four patients subsequently died (LM) and 35 patients underwent re‐LT (LGL). Patients who survive the first posttransplant year had 5‐year patient and graft survival rates of 94.2% and 89.2%, respectively. Graft loss after the first year was caused by rejection in 49% of the cases with sequelae of technical complications accounting for an additional 20% of LGL. LT for tumor, steroid resistant rejection, reoperation in the first 30 days and >5 admissions during the first posttransplant year were independently associated with LGL in multivariate analysis. Malignancy, infection, multiple system organ failure and posttransplant lymphoproliferative disease accounted for 61.8% of all late deaths after LT. LT performed for FHF and tumor were associated with LM. Patients who are at or below the mean for weight at the time of transplant were also at an increased risk of dying. Frequent readmission was also found to be associated with LM. Late graft loss (LGL) and late mortality (LM) following liver transplantation (LT) in children were analyzed from the studies of pediatric liver transplantation (SPLIT) database. Univariate and multivariate associations between pre‐ and postoperative factors and LGL and LM in 872 patients alive with their primary allografts 1 year after LT were reviewed. Thirty‐four patients subsequently died (LM) and 35 patients underwent re‐LT (LGL). Patients who survive the first posttransplant year had 5‐year patient and graft survival rates of 94.2% and 89.2%, respectively. Graft loss after the first year was caused by rejection in 49% of the cases with sequelae of technical complications accounting for an additional 20% of LGL. LT for tumor, steroid resistant rejection, reoperation in the first 30 days and >5 admissions during the first posttransplant year were independently associated with LGL in multivariate analysis. Malignancy, infection, multiple system organ failure and posttransplant lymphoproliferative disease accounted for 61.8% of all late deaths after LT. LT performed for FHF and tumor were associated with LM. Patients who are at or below the mean for weight at the time of transplant were also at an increased risk of dying. Frequent readmission was also found to be associated with LM.