PEDIATRIC LIVER-TRANSPLANTATION - QUEEN-MARY-HOSPITAL EXPERIENCE

Objective To assess the results of paediatric liver transplantation in our institution. Methods From September 1993 to November 1996, 10 liv ing-related liver transplants (LRLT) and 3 reduced-size liver transpla nts (RSLT) were performed on 12 children at our hospital. The medical records of the patients were reviewed. All patients suffered from end- stage liver disease resulting from biliary atresia with failed Kasai's operations. Their ages at initial transplantation ranged from 8 month s to 11 years. Excluding the 2 older children aged 7.5 and 11 years, t he remaining patients were aged 10.5 months on the average and weighed 6 to 9.5 kg (mean: 6.8 kg) at the time of initial transplantation. Re sults Ail living donors were discharged on postoperative day 4 to 8 an d resumed their previous normal activities. AII recipients were alive with normal liver function and growing after a follow-up period of 3-4 0 months (mean: 21 months). The patient survival rate was 100%. One pa tient with RSLT had hepatitis of undetermined aetiology and underwent retransplant with a graft from her mother. The graft survival rate was 92%. Postoperative complications included: postoperative bleeding (n= 3), hepatic vein stenosis (n=1), biliary-enteric anastomotic stenosis (n=3), intestinal perforation (n=1) and portal vein thrombosis (n= 1). They were all treated promptly. In all patients, the hepatic artery ( diameter ranged from 1.5 to 2.5 mm) anastomosis was achieved by microv ascular technique. There was no hepatic artery thrombosis in our patie nts. Conclusion With technical refinements, early detection and prompt treatment of complications, and advances in immunotherapy, excellent results can be achieved in paediatric liver transplantation.