1998 Volume 34 Issue 7 Pages 1145-1151
From 1985 to 1995, 153 children received 176 liver grafts, including 109 reduced-size liver grafts (RLGs) and 67 whole liver grafts (WLGs), at the Queensland Liver Transplant Service, Brisbane, Australia. Twenty-eight children (18%) were less than one-year-old at the time of transplantation. Retransplantation was performed on 21 children (14%). The 1, 5, and 10-year patient survival rates were 88, 75, and 70%, respectively. There were no differences in patient or graft survival rates between transplants using RLGs and WLGs. Major causes of post-trans-plant mortality were sepsis (32%), hemorrhage (16%), and rejection (14%). Portal vein thrombosis, hepatic artery thrombosis, and biliary complication were experienced in 8, 7, and 16%, respectively. Post-transplant gastrointestinal perforation occurred in 15% of the cases that underwent previous laparotomy. Of the 115 children surviving more than one year postoperatively, 111 (97%) were well and leading normal active lives with normal liver function. Growth and development of the children were essentially normal after one year posttransplant, with growth at a normal rate in 92% and remarkable catch-up in 5%. Liver transplantation provides a cure and normal development for children with end-stage liver disease. The establishment of life-long follow-up for recipients is expected to warrant better long-term survival.
