Surgical complications and long-term outcome in pediatric liver transplantation

Background/Aims: Liver transplantation has been widely accepted for the tre atment of children with end-stage liver disease over the last 10 years part icularly with the advent of reduced-size liver transplant technique. This s tudy reviewed the perioperative and long-term results in the pediatric prog ram of the Queensland Liver Transplant Service, Brisbane, Australia. Methodology: Retrospective analysis was performed in 153 children who recei ved 176 liver grafts between 1985 and 1995, including 109 (62%) reduced-siz e and 67 (38%) whole liver grafts. Median follow-up period was 5.3 years. Results: One-, 5-, and 10-year patient and graft survival rates were 82% an d 74%, 75% and 63%, and 70% and 60%, respectively. Normal physical and inte llectual development was observed in 98% of survivors. There were no signif icant differences in patient or graft survival rates between transplants us ing reduced-size and whole liver grafts. Portal vein thrombosis was the mos t common vascular complication, occurring in 8%. Hepatic artery thrombosis occurred in 7%, including 11% of children less than 1 year old and 8% of th ose under 10kg. Biliary complication was found in 16% and posttransplant ga strointestinal perforation in 19%. Conclusions: Liver transplantation has the potential to cure and allow deve lopment in children with end-stage liver disease.