Liver Transplantation for Children: Red Cross Children's Hospital Experience

The liver transplant program for infants and children at the Red Cross Children's Memorial Hospital is the only established pediatric service in sub-Saharan Africa. Since 1985, 250 infants and children have been assessed and 155 accepted for transplantation. Since 1987, 76 children (range 6 mon...

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Bibliographic Details
Published in:Transplantation proceedings 2005-03, Vol.37 (2), p.1134-1137
Main Authors: Spearman, C.W.N., McCulloch, M., Millar, A.J.W., Burger, H., Numanoglu, A., Goddard, E., Cooke, L., Cywes, S., Rode, H., Kahn, D.
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Child, Preschool
Communicable Disease Control - methods
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Hospitals, Pediatric
Humans
Immunosuppression - methods
Infant
Liver Diseases - classification
Liver Diseases - surgery
Liver Transplantation - methods
Liver Transplantation - mortality
Male
Medical sciences
Postoperative Complications - epidemiology
Postoperative Complications - prevention & control
Red Cross
Retrospective Studies
South Africa
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Survival Analysis
Tissue, organ and graft immunology
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Summary:The liver transplant program for infants and children at the Red Cross Children's Memorial Hospital is the only established pediatric service in sub-Saharan Africa. Since 1985, 250 infants and children have been assessed and 155 accepted for transplantation. Since 1987, 76 children (range 6 months to 14 years) have had 79 liver transplants, with biliary atresia being the most frequent diagnosis. The indications for transplantation include biliary atresia (n = 44), metabolic (n = 7), fulminant hepatic failure (n = 10), redo transplants (n = 3), and other (n = 15). Three combined liver/kidney transplants have been performed. Forty-nine were reduced-size transplants with donor: recipient weight ratios ranging from 2:1 to 11:1, and 29 children weighed < 10 kg. Fifty-six (74%) patients survived 3 months to 12 years posttransplant. Cumulative 1- and 5-year patient survival data are 79% and 70%, respectively. However, with the introduction of prophylactic intravenous gancyclovir and the exclusion of hepatitis B virus (HBV) IgG core Ab-positive donors, the projected 5-year pediatric survival has been >80%. Early (
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2004.12.285