Introduction: The Japanese liver transplantation society (JLTS), a cooperative research consortium, was established in 1980, in order to characterize and follow trends in patients and graft survival in all liver transplants in Japan. This study analyzes comprehensive factors that may influence outcome of pediatric patients who underwent LDLT in largest cohort in the world.
Methods: Between November 1989 and December 2010, 2224 patients received LDLT in Japan. The survival of each of the donor and recipient variants were evaluated.
Results: There were 998 male (44.9%) and 1,226 female donors (55.1%) with a median age of 35.2 years (range: 17~70 years) and body weight of 59 kg (range: 36~103kg). There was no donor mortality related to the surgery. There were 946 male (42.5%) and 1,278 female (57.5%) recipients with a median age of the recipient of 4.0 years (range;13 days~17.9 years) and body weight of 16.6kg (range:2.6~90kg). Cholestatic liver disease was the leading indication for LDLT (n=1,649; 76.2%), following metabolic disorders (n=194; 8.7%), acute liver failure (n=192; 8.6%), and neoplastic liver disease (n=66; 3.0%). The 1/ 5/ 10/ 20 year patient survival were 88.3/ 85.4/ 82.8/ 79.6%. Blood type incompatibility, recipient age, etiology of liver disease and transplant era were significant predictors for overall survival.
Conclusons: We conclude that pediatric LDLT is a safe and an effective treatment modality without compromising live donors. The significant factors affecting survival could be overcome by technical and immunological refinements in recent years.
Volume : 11
Issue : 6
Pages : 5
Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan