Outcomes for children after second liver transplantations are similar to those after first transplantations: a binational registry analysis.
Adult
Australia
/ epidemiology
Child
Child, Preschool
Female
Follow-Up Studies
Graft Survival
Humans
Infant
Kaplan-Meier Estimate
Liver Transplantation
/ methods
Male
New Zealand
/ epidemiology
Proportional Hazards Models
Registries
Reoperation
Retrospective Studies
Tissue Donors
Treatment Outcome
Waiting Lists
Ethics
Liver diseases
Liver transplantation
Tissue and organ procurement
Journal
The Medical journal of Australia
ISSN: 1326-5377
Titre abrégé: Med J Aust
Pays: Australia
ID NLM: 0400714
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
16
03
2020
accepted:
10
07
2020
pubmed:
6
10
2020
medline:
12
1
2021
entrez:
5
10
2020
Statut:
ppublish
Résumé
To assess long term graft and patient survival after donor liver retransplantation in children in Australia and New Zealand during 1986-2017; to determine the factors that influence survival. Retrospective cohort analysis (registry data). Australia and New Zealand Liver Transplant Registry data for all liver retransplantations in children (under 18 years of age), 1986-2017, in all four paediatric and six adult liver transplantation centres in the two countries. Graft and patient survival at one, 5, 10 and 15 years. 142 liver retransplantations were undertaken in children (59 during 1986-2000, 83 during 2001-2017). Kaplan-Meier survival analysis indicated that survival was significantly greater during 2001-2017 than 1986-2000 (P < 0.001). During 2001-2017, graft survival one year after retransplantation was 84%, at 5 years 75%, at 10 years 70%, and at 15 years 54%; patient survival was 89% at one year, 87% at 5 years, 87% at 10 years, and 71% at 15 years. Median time between transplantations was 0.2 years (IQR, 0.03-1.4 years) during 1986-2000, and 1.8 years (IQR, 0.1-6.8 years) during 2001-2017 (P = 0.002). The proportion of graft failures that involved split grafts was larger during 2001-2017 (35 of 83, 42%) than 1986-2000 (10 of 59, 17%). Graft type, cause of graft failure, and number of transplants did not influence survival following retransplantation. Survival for children following retransplantation is excellent. Graft survival is similar for split and whole grafts. Children on the liver waiting list requiring retransplantation should have the same access to donor grafts as children requiring a first transplant.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
464-470Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 AMPCo Pty Ltd.
Références
Goss JA, Shackleton CR, McDiarmid SV, et al. Long-term results of pediatric liver transplantation: an analysis of 569 transplants. Ann Surg 1998; 228: 411-420.
Sánchez-Bueno F, Acosta F, Ramirez P, et al. Incidence and survival rate of hepatic retransplantation in a series of 300 orthotopic liver transplants. Transplant Proc 2000; 32: 2671-2672.
Ng V, Anand R, Martz K, Fecteau A. Liver retransplantation in children: a SPLIT database analysis of outcome and predictive factors for survival. Am J Transplant 2008; 8: 386-395.
Deshpande RR, Rela M, Girlanda R, et al. Long-term outcome of liver retransplantation in children. Transplantation 2002; 74: 1124-1130.
Sieders E, Peeters PMJG, TenVergert EM, et al. Retransplantation of the liver in children. Transplantation 2001; 71: 90.
Newell KA, Millis JM, Bruce DS, et al. An analysis of hepatic retransplantation in children. Transplantation 1998; 65: 1172.
Ogura Y, Kaihara S, Haga H, et al. Outcomes for pediatric liver retransplantation from living donors. Transplantation 2003; 76: 943.
Kim WR, Lake JR, Smith JM, et al. Liver. Am J Transplant 2016; 16 (Suppl 2): 69-98.
Fink MA, Berry SR, Gow PJ, et al. Risk factors for liver transplantation waiting list mortality. J Gastroenterol Hepatol 2007; 22: 119-124.
Transplantation Society of Australia and New Zealand. Clinical guidelines for organ transplantation from deceased donors; version 1.3. May 2019. https://tsanz.com.au/guidelinesethics-documents/organallocationguidelines.htm (viewed Mar 2020).
Neuberger J, James O. Guidelines for selection of patients for liver transplantation in the era of donor-organ shortage. Lancet 1999; 354: 1636-1639.
Biggins SW. Futility and rationing in liver retransplantation: when and how can we say no? J Hepatol 2012; 56: 1404-1411.
Huesch MD. One and done? Equality of opportunity and repeated access to scarce, indivisible medical resources. BMC Med Ethics 2012; 13: 11.
Davis A, Rosenthal P, Glidden D. Pediatric liver retransplantation: outcomes and a prognostic scoring tool. Liver Transpl 2009; 15: 199-207.
Oswari H, Lynch SV, Fawcett J, et al. Outcomes of split versus reduced-size grafts in pediatric liver transplantation. J Gastroenterol Hepatol 2005; 20: 1850-1854.
Vulchev A, Roberts JP, Stock PG. Ethical issues in split versus whole liver transplantation. Am J Transplant 2004; 4: 1737-1740.
Diamond IR, Fecteau A, Millis JM, et al. Impact of graft type on outcome in pediatric liver transplantation: a report from Studies of Pediatric Liver Transplantation (SPLIT). Ann Surg 2007; 246: 301-310.
Australia and New Zealand Liver Transplant Registry. 30th annual ANZLITR report. Report on liver and intestinal transplantation activity to 31/12/2018. 2020. https://www3.anzltr.org/wp-content/uploads/Reports/30thReport.pdf (viewed Mar 2020).
Battula NR, Platto M, Anbarasan R, et al. Intention to split policy: a successful strategy in a combined pediatric and adult liver transplant center. Ann Surg 2017; 265: 1009-1015.
McDiarmid SV, Anand R, Lindblad AS. Principal Investigators and Institutions of the Studies of Pediatric Liver Transplantation (SPLIT) Research Group. Development of a pediatric end-stage liver disease score to predict poor outcome in children awaiting liver transplantation. Transplantation 2002; 74: 173-181.
Jeffrey AW, Delriviere L, McCaughan G, et al. Excellent contemporary graft survival for adult liver retransplantation: an Australian and New Zealand registry analysis from 1986 to 2017. Transplant Direct 2019; 5: e427.
Heffron TG, Pillen T, Smallwood G, et al. Liver retransplantation in children: the Atlanta experience. Pediatr Transplant 2010; 14: 417-425.
McDiarmid SV, Merion RM, Dykstra DM, Harper AM. Selection of pediatric candidates under the PELD system. Liver Transpl 2004; 10 (Suppl 10): S23-S30.
Annunziato RA, Emre S, Shneider B, et al. Adherence and medical outcomes in pediatric liver transplant recipients who transition to adult services. Pediatr Transplant 2007; 11: 608-614.
Mitchell T, Gooding H, Mews C, et al. Transition to adult care for pediatric liver transplant recipients: the Western Australian experience. Pediatr Transplant 2017; 21: e12820.