TY - JOUR
T1 - European Liver Transplant Registry
T2 - Donor and transplant surgery aspects of 16,641 liver transplantations in children
AU - European Liver, Intestine Transplant Association (ELITA)
AU - de Ville de Goyet, Jean
AU - Baumann, Ulrich
AU - Karam, Vincent
AU - Adam, René
AU - Nadalin, Silvio
AU - Heaton, Nigel
AU - Reding, Raymond
AU - Branchereau, Sophie
AU - Mirza, Darius
AU - Klempnauer, Jürgen L
AU - Fischer, Lutz
AU - Kalicinski, Piotr
AU - Colledan, Michele
AU - Lopez Santamaria, Manuel
AU - de Kleine, Ruben H
AU - Chardot, Christophe
AU - Yilmaz, Sezai
AU - Kilic, Murat
AU - Boillot, Olivier
AU - di Francesco, Fabrizio
AU - Polak, Wojciech G
AU - Verkade, Henkjan J
N1 - This article is protected by copyright. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - BACKGROUND & AIMS: The European Liver Transplant Registry (ELTR) has collected data on liver transplant procedures performed in Europe since 1968.APPROACH & RESULTS: Over a 50 years period (1968 - 2017), clinical and laboratory data were collected from 133 transplant centers and analyzed retrospectively (16,641 liver transplants in 14,515 children). Data were analyzed according to 3 successive periods (A: before 2000, B: 2000 to 2009, and C: since 2010), studying donor and graft characteristics, and graft outcome. The use of living donors steadily increased from A to C [A: n=296 (7%), B: n=1131 (23%) and C: n=1985 (39%); P=0.0001]. Overall, the 5-year graft survival rate has improved from 65% in group A to 75% in group B (p<0.0001), and to 79% in group C (B vs C, p<0.0001). Graft half-life was 31 years, overall; it was 41 years for children who survived the first year after transplant. The late annual graft loss rate in teen-agers is higher than children aged < 12 years, and similar to that of young adults. No evidence for accelerated graft loss after age 18 year was found.CONCLUSIONS: Pediatric liver transplantation has reached a high efficacy as a cure, or treatment, for severe liver disease in infants and children. Grafts that survived the first year had a half-life time similar to standard human half-life. Transplantation before or after puberty may be the pivot-point for lower long-term outcome in children. Further studies are necessary to re-visit some old concepts regarding transplant benefit (survival time) for small children, the role of recipient pathophysiology versus graft aging, and risk at transition to adult age.
AB - BACKGROUND & AIMS: The European Liver Transplant Registry (ELTR) has collected data on liver transplant procedures performed in Europe since 1968.APPROACH & RESULTS: Over a 50 years period (1968 - 2017), clinical and laboratory data were collected from 133 transplant centers and analyzed retrospectively (16,641 liver transplants in 14,515 children). Data were analyzed according to 3 successive periods (A: before 2000, B: 2000 to 2009, and C: since 2010), studying donor and graft characteristics, and graft outcome. The use of living donors steadily increased from A to C [A: n=296 (7%), B: n=1131 (23%) and C: n=1985 (39%); P=0.0001]. Overall, the 5-year graft survival rate has improved from 65% in group A to 75% in group B (p<0.0001), and to 79% in group C (B vs C, p<0.0001). Graft half-life was 31 years, overall; it was 41 years for children who survived the first year after transplant. The late annual graft loss rate in teen-agers is higher than children aged < 12 years, and similar to that of young adults. No evidence for accelerated graft loss after age 18 year was found.CONCLUSIONS: Pediatric liver transplantation has reached a high efficacy as a cure, or treatment, for severe liver disease in infants and children. Grafts that survived the first year had a half-life time similar to standard human half-life. Transplantation before or after puberty may be the pivot-point for lower long-term outcome in children. Further studies are necessary to re-visit some old concepts regarding transplant benefit (survival time) for small children, the role of recipient pathophysiology versus graft aging, and risk at transition to adult age.
KW - RECIPIENTS
KW - SURVIVAL
KW - COMPLICATIONS
U2 - 10.1002/hep.32223
DO - 10.1002/hep.32223
M3 - Article
C2 - 34724224
SN - 0270-9139
VL - 75
SP - 634
EP - 645
JO - Hepatology
JF - Hepatology
IS - 3
ER -