ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network

Children

on behalf of ERN TransplantChild Healthcare Working Group¹  Juan Torres Canizales²  Eduardo Lopez-Granados²  Marco Spada³  Daniela Liccardo⁴  Andrea Pietrobattista⁴  Maria-Sole Basso⁴  Angelo Di Giorgio⁵  Piotr Kaliciński⁶  Małgorzata Markiewicz-Kijewska⁶  Grzegorz Kowalewski⁶  Maria Francelina Lopes⁷  Carl Jorns⁸  Ulrich Baumann⁹  Sandra Ferreira^1,10  Alastair Baker^1,11  Paloma Jara Vega^1,12  Esteban Frauca Remacha^1,12  Diana Kamińska^1,13 

[1] ;Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Lymphocyte Pathophysiology in Immunodeficiencies Group, Immunology Unit, La Paz Institute of Biomedical Research (IdiPAZ), La Paz University Hospital, 28046 Madrid, Spain;Department of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy;Department of Hepatology, Gastroenterology and Nutrition, Ospedale Pediatrico Bambino Gesu, 00165 Roma, Italy;Department of Pediatric Hepatology, Gastroenterology and Transplantation, ASST Hospital Papa Giovanni XXIII, 24127 Bergamo, Italy;Department of Pediatric Surgery and Organ Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, Poland;Department of Pediatric Surgery, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;Department of Transplantation Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden;Division of Pediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, Germany;Hepatology and Pediatric Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, Portugal;Pediatric Liver, Gastrointestinal and Nutrition Centre, King’s College London School of Medicine, King’s College Hospital, Denmark Hill, London SE5 9RS, UK;Servicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, Spain;The Department of Gastroenterology, Hepatology, Nutrition Disorder and Pediatric, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;

关键词: AB0-incompatible liver transplantation;    children;    immunosuppression;    rejection;    complications;    patient survival;   

DOI  :  10.3390/children8090760

来源: DOAJ

【 摘 要 】

An increasing number of AB0-incompatible (AB0i) liver transplantations (LT) are being undertaken internationally in recent years due to organ shortages and the need for urgent transplantation. The aim of our study was establish the value of ABOi LT from available retrospective results of AB0i pediatric liver transplantations performed in European reference centers now belonging to the TransplantChild, European Reference Network (ERN). Data from medical records were analyzed, including demographic data, diagnosis, urgency of transplantation, time on the waiting list, PELD/MELD score, desensitization procedures, immunosuppression, selected post-transplant complications, and patient and graft survival. A total of 142 patients (pts) with transplants between 1986 and 2018 in 8 European transplant centers were included in the study. The indications for liver transplantation were: cholestatic diseases in 62 pts, acute liver failure in 42 pts, and other conditions in the remaining 38 pts. Sixty-six patients received grafts from living donors, and seventy-six received grafts from deceased donors. Both patient and graft survival were significantly affected by deceased donor type, urgent transplantation, and the development of vascular complications. In the multivariate analysis, vascular complications had a negative impact on patient and graft survival, while a longer time from the first AB0i LT in the study showed better results, suggesting an international learning experience. In conclusion, we believe that AB0i LT in children is now a safe procedure that may be adopted more readily in children.

【 授权许可】

Unknown