ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network

An increasing number of AB0-incompatible (AB0i) liver transplantations (LT) are being undertaken internationally in recent years due to organ shortages and the need for urgent transplantation. The aim of our study was establish the value of ABOi LT from available retrospective results of AB0i pediatric liver transplantations performed in European reference centers now belonging to the TransplantChild, European Reference Network (ERN). Data from medical records were analyzed, including demographic data, diagnosis, urgency of transplantation, time on the waiting list, PELD/MELD score, desensitization procedures, immunosuppression, selected post-transplant complications, and patient and graft survival. A total of 142 patients (pts) with transplants between 1986 and 2018 in 8 European transplant centers were included in the study. The indications for liver transplantation were: cholestatic diseases in 62 pts, acute liver failure in 42 pts, and other conditions in the remaining 38 pts. Sixty-six patients received grafts from living donors, and seventy-six received grafts from deceased donors. Both patient and graft survival were significantly affected by deceased donor type, urgent transplantation, and the development of vascular complications. In the multivariate analysis, vascular complications had a negative impact on patient and graft survival, while a longer time from the first AB0i LT in the study showed better results, suggesting an international learning experience. In conclusion, we believe that AB0i LT in children is now a safe procedure that may be adopted more readily in children.

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Type of Preservation Solution, UW or HTK, Has an Impact on the Incidence of Biliary Stricture following Liver Transplantation: A Retrospective Study

Journal of Transplantation ◽

10.1155/2019/8150736 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Rojbin Karakoyun ◽

Antonio Romano ◽

Johan Nordström ◽

Bo-Göran Ericzon ◽

Greg Nowak

Keyword(s):

Liver Transplantation ◽

Graft Survival ◽

Biliary Stricture ◽

Solid Organ Transplantation ◽

Vascular Complications ◽

Blood Chemistry ◽

Liver Graft ◽

Solid Organ ◽

Preservation Solution ◽

Patient And Graft Survival

Organ preservation plays a crucial role in the outcome following solid organ transplantation. The aim of this study was to perform a retrospective outcome analysis following liver transplantation using histidine tryptophan ketoglutarate (HTK) or the University of Wisconsin (UW) solutions for liver graft preservation. We retrospectively reviewed data on adult patients who were liver-transplanted at Karolinska University Hospital between 2007 and 2015. There was evaluation of donor and recipient characteristics, pre- and post-transplant blood chemistry tests, biliary and vascular complications, graft dysfunction and nonfunction, and patient and graft survivals. A total of 433 patients were included in the analyses, with 230 and 203 patients having received livers preserved with HTK and UW, respectively. Mean follow-up was 45 ± 29 months for the HTK group and 42.4 ± 26 for the UW group. There was no difference between the two groups either in terms of patient and graft survival, or of results of postoperative blood chemistry, or incidence of arterial complications, early allograft dysfunction, or primary graft nonfunction. However, the incidence of biliary stricture was higher in the UW group (22.7%) versus the HTK group (13.5%; p=0.013). Use of UW and HTK preservation solution in liver transplantation has no impact on patient and graft survival. However, use of HTK solution results in a lower incidence of posttransplant biliary stricture.

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Negative Impact of New-Onset Diabetes Mellitus on Patient and Graft Survival After Liver Transplantation: Long-Term Follow Up

Transplantation Journal ◽

10.1097/01.tp.0000250361.60415.96 ◽

2006 ◽

Vol 82 (12) ◽

pp. 1625-1628 ◽

Cited By ~ 121

Author(s):

Jang I. Moon ◽

Ralph Barbeito ◽

Raquel N. Faradji ◽

Jeffrey J. Gaynor ◽

Andreas G. Tzakis

Keyword(s):

Diabetes Mellitus ◽

Liver Transplantation ◽

Graft Survival ◽

Negative Impact ◽

Long Term Follow Up ◽

New Onset Diabetes Mellitus ◽

Patient And Graft Survival ◽

New Onset

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NEGATIVE IMPACT OF POST TRANSPLANT DIABETES MELLITUS AFTER LIVER TRANSPLANTATION ON PATIENT AND GRAFT SURVIVAL IN LONG-TERM FOLLOW UP.

Transplantation Journal ◽

10.1097/00007890-200607152-00277 ◽

2006 ◽

Vol 82 (Suppl 2) ◽

pp. 159-160

Author(s):

&NA;

Keyword(s):

Diabetes Mellitus ◽

Liver Transplantation ◽

Graft Survival ◽

Negative Impact ◽

Post Transplant ◽

Long Term Follow Up ◽

Patient And Graft Survival

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P42 Predictors of patient and graft survival following pediatric liver transplantation: Long-term analysis of more than 300 cases from single centre

10.1136/flgastro-2021-bspghan.51 ◽

2021 ◽

Author(s):

Amr Alnagar ◽

Khaled Daradka ◽

Eirini Kyrana ◽

Marumbo Methga ◽

Karthikeyan Palaniswamy ◽

...

Keyword(s):

Liver Transplantation ◽

Graft Survival ◽

Pediatric Liver Transplantation ◽

Single Centre ◽

Pediatric Liver ◽

Term Analysis ◽

Patient And Graft Survival

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Both Alcoholic and Nonalcoholic Steatohepatitis Is an Emerging Indication for Liver Transplantation in the United States

Digestive Disease Interventions ◽

10.1055/s-0040-1713369 ◽

2020 ◽

Vol 04 (02) ◽

pp. 223-234

Author(s):

Danielle Fritze ◽

Amandeep Singh ◽

Eric Lawitz ◽

Kris V. Kowdley ◽

Glenn Halff ◽

...

Keyword(s):

United States ◽

Liver Transplantation ◽

Graft Survival ◽

Nonalcoholic Steatohepatitis ◽

Multivariable Analysis ◽

Deceased Donor ◽

The United States ◽

Hispanic Males ◽

Patient And Graft Survival ◽

United Network

Abstract Background Nonalcoholic steatohepatitis (NASH) and alcoholic liver disease (ALD) are now the most common indications for liver transplantation (LT) in the United States. A subset of patients have both alcoholic and nonalcoholic steatohepatitis (BASH). This study characterizes patients with BASH requiring LT and assesses changes in the prevalence of BASH as an indication for LT. Methods The United Network for Organ Sharing database was analyzed for all patients ≥ 18 years of age who received their first deceased donor LT from 2002 to 2016 for ALD, NASH, or BASH. Baseline demographics, clinical parameters, and LT outcomes were compared between groups. Results Since 2002, 85,448 patients underwent LT:15,327 had ALD, 9,971 had NASH, and 2,779 had BASH. The prevalence of BASH as an indication for LT increased from 0.5% in 2002 to 5% in 2016. Compared with patients with NASH, those with BASH were significantly more likely to be male (85.6 vs. 57%), younger (mean 56.4 vs. 58.6 years), and Hispanic (22.2 vs. 13.6%) (p < 0.001 for all). While indication for transplant was not significantly associated with transplant outcomes on multivariable analysis, patient and graft survival curves do differ significantly by indication for transplant, with worse outcomes for patients with BASH (patient survival at 5 years: NASH 78.1%, ALD 77.2%, BASH 73.5%, p = 0.013; graft survival at 5 years: NASH 75.3%, ALD 74.0%, BASH 70.8%, p = 0.046). Conclusions BASH is a rising indication for LT, especially for Hispanic males, due to the increasing prevalence of ALD and NASH in the United States.

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