Liver transplantation in children with fulminant hepatic failure: The UCL experience

:  The outcome of pediatric LT for FHF was shown to be poor in our center. To better understand such results, recipient and transplant parameters with a putative impact on post‐transplant outcome were analyzed in LT for FHF. Between March 1984 and June 2002, 33 children with FHF received a primary l...

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Bibliographic Details
Published in:Pediatric transplantation 2009-06, Vol.13 (4), p.414-420
Main Authors: Mahadeb, Parikshat, Gras, Jérémie, Sokal, Etienne, Otte, Jean-Bernard, Lerut, Jan, Detaille, Thierry, De Cléty, Stéphan Clément, Reding, Raymond
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Child, Preschool
children
failure
Female
fulminant
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
hepatic
Humans
Infant
Liver Failure, Acute - etiology
Liver Failure, Acute - mortality
Liver Failure, Acute - surgery
liver transplantation
Liver Transplantation - mortality
Liver, biliary tract, pancreas, portal circulation, spleen
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Other diseases. Semiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Survival Analysis
Treatment Outcome
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Summary::  The outcome of pediatric LT for FHF was shown to be poor in our center. To better understand such results, recipient and transplant parameters with a putative impact on post‐transplant outcome were analyzed in LT for FHF. Between March 1984 and June 2002, 33 children with FHF received a primary liver allograft. The overall results in this series were studied with respect to pre‐operative demographic and metabolic variables, peri‐operative events, and outcome. Five‐yr patient and graft survivals were 71% and 66%, respectively, with a retransplantation rate at 18%. Incidences of perioperative hemorrhage, of HAT and PVT were 14%, 8%, and 4%, respectively. Five‐yr acute rejection‐free survival rate was 55%. These data confirm the worse outcome following LT for FHF when compared with LT in elective, non‐malignant indications such as BA; results in FHF could not be related to surgical or immunological complications in the post‐transplant period and it is hypothesized that the MOF associated with FHF contributes to early post‐transplant mortality which would justify special management, including aggressive renal and hepatic support.
ISSN:1397-3142
1399-3046
DOI:10.1111/j.1399-3046.2008.01008.x