The impact of low recipient weight [≤ 7kg] on long-term outcomes in 1078 pediatric living donor liver transplantations

J Pediatr Surg. 2022 Dec;57(12):955-961. doi: 10.1016/j.jpedsurg.2022.05.014. Epub 2022 May 22.

Abstract

Background: infants who require liver transplantation represent a treatment challenge because chronic liver disease at this early age affects the child's growth and development during a critical phase. The aim is to compare demographics, operative data, and long-term outcomes according to recipient weight at the time of LDLT.

Methods: This retrospective study included primary LDLT analyzed in 2 groups: BW ≤ 7 kg (n = 322) and BW > 7 kg (n = 756). A historical comparison between periods was also investigated.

Results: BW ≤ 7 kg had significantly lower height/age and weight/age z-scores, with median PELD score of 19. Transfusion rates were higher in the BW ≤ 7 kg group (30.9 ml/kg versus 15.5 ml/kg, P < 0.001). Higher frequencies of PV complications were seen in the BW ≤ 7 kg cohort. HAT and retransplantation rates were similar. Those with BW ≤ 7 kg required longer ICU and hospital stays. Patient and graft survival were similar. Patient survival in BW≤ 7 kg was significantly better in the most recent period.

Conclusion: Malnutrition and advanced liver disease were more frequent in BW ≤ 7 kg. Despite increased rates of PVT and longer hospital stay, patient and graft long-term survival were similar between groups.

Keywords: Children; Hepatic artery thrombosis; LEVEL III; Level of evidence; Liver transplantation; Living donation; Outcomes.

MeSH terms

  • Child
  • Graft Survival
  • Humans
  • Infant
  • Liver Transplantation*
  • Living Donors*
  • Retrospective Studies
  • Treatment Outcome