Abstract
Segmental liver transplantation with living donor (LD), reduced cadaveric (Reduced), and split cadaveric (Split) allografts has expanded the availability of size-appropriate organs for pediatric recipients. The relevance of recipient age to the selection of graft type has not been fully explored, but could offer the potential to maximize recipient outcome and donor utilization. We conducted a retrospective cohort study among children 12 years of age or less utilizing the United Network of Organ Sharing (UNOS) database. Cox proportional-hazards analysis was used to explore the association of recipient age and graft type to graft and patient survival. Among children <1 year of age and those 1 to 2 years of age, 3-year LD graft survival was superior to whole cadaveric (CAD) organs, Split grafts, and Reduced grafts (for children <1 year of age: 79.4 vs. 61.5, 66.0, and 61.1%, respectively, P = .0003; and for children 1-2 years of age: 79.2 vs 66.9, 57.1, and 63.9%, respectively, P = .02). However, in children 3 to 12 years of age, after controlling for multiple donor and recipient factors, LD grafts failed to offer a survival advantage (hazard ratio = .61; 95% confidence interval = .37-1.02) compared to CAD organs. In an adjusted a...Continue Reading
References
Feb 1, 1990·Annals of Surgery·J B OtteP Clapuyt
Jun 1, 1989·Transplantation·V MazzaferroA G Tzakis
Apr 1, 1993·Transplantation·J C EmondP F Whitington
Jan 1, 1995·Journal of Pediatric Surgery·O JurimR W Busuttil
Apr 1, 1993·Transplantation·R J PloegM Kalayoglu
Sep 1, 1996·Annals of Surgery·X RogiersC E Broelsch
Oct 1, 1996·Annals of Surgery·J C EmondN L Ascher
Jul 27, 1997·Transplantation·T V CacciarelliS K So
Jun 26, 1998·Pediatric Surgery International·J B OtteF Libert
Sep 22, 1998·Annals of Surgery·J A GossR W Busuttil
Feb 18, 1999·Journal of Pediatric Surgery·R SindhiH B Othersen
Feb 25, 1999·Transplantation·J PratschkeN L Tilney
Feb 12, 1999·Transplantation·T KiuchiK Tanaka
Sep 10, 1999·Transplantation·E SiedersM J Slooff
Aug 15, 2001·Transplantation·UNKNOWN SPLIT Research Group
Dec 1, 2001·Annals of Surgery·D C BroeringX Rogiers
Dec 12, 2001·Transplantation·D G FarmerR W Busuttil
Dec 26, 2001·Annals of Surgery·Egbert SiedersMaarten J H Slooff
Aug 10, 2002·Annals of Surgery·Rahul R DeshpandeMohamed Rela
Apr 30, 2003·Transplantation·Bruno GridelliGiuliano Torre
Citations
Aug 2, 2007·Annals of Surgery·Ivan R DiamondUNKNOWN SPLIT Research Group
May 25, 2011·Annals of Surgery·Sue V McDiarmidGeorge Mazariegos
May 24, 2008·Transplantation·Abhinav HumarWilliam Payne
Sep 29, 2011·Journal of Paediatrics and Child Health·Felix Oberender
Jul 18, 2006·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Teresa BerrocalManuel López Santamaría
Apr 8, 2010·Pediatric Clinics of North America·Binita M Kamath, Kim M Olthoff
May 30, 2009·Journal of the American College of Surgeons·Johnny C HongRonald W Busuttil
Aug 12, 2008·Current Problems in Surgery·Dieter C BroeringXavier Rogiers
Jan 15, 2008·Journal of Vascular and Interventional Radiology : JVIR·Darice LiuSue V McDiarmid
May 8, 2007·Journal of the American College of Surgeons·Douglas G FarmerRonald W Busuttil
Jun 10, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Timothy C LeeJohn A Goss
Jun 14, 2005·Transplant International : Official Journal of the European Society for Organ Transplantation·Hugo BonattiAlfred Königsrainer
Feb 5, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J C LaiR S Brown
Aug 1, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Natasha S BeckerJohn A Goss
Aug 1, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sandy Feng
Jul 26, 2006·Journal of the American College of Surgeons·Peter L AbtArun K Singhal
Dec 19, 2015·International Journal of Hepatology·Sona ChandraNitika Arora Gupta
Sep 15, 2015·PloS One·Hui YeXiaoshun He
Oct 6, 2016·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Evelyn K Hsu, George V Mazariegos
Sep 11, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Mureo KasaharaUNKNOWN Japanese Liver Transplantation Society
Sep 27, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Neal R BarshesJohn A Goss
Sep 2, 2005·Annals of Surgery·Kim M OlthoffUNKNOWN A2ALL Study Group
Aug 19, 2013·Clinical Liver Disease·Paige M Porret, Kim M Olthoff
Oct 7, 2017·Pediatric Surgery International·Mureo KasaharaShinji Uemoto
Mar 27, 2020·Pediatric Transplantation·Karina CovarrubiasDouglas B Mogul
Jan 9, 2018·The Journal of Pediatrics·Douglas B MogulDorry L Segev
Dec 1, 2020·Clinics and Research in Hepatology and Gastroenterology·Olivier BoillotJérôme Dumortier
Aug 1, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Alexandra ShinginaJoseph Kim
Oct 16, 2021·Current Opinion in Organ Transplantation·Ngee-Soon LauCarlo Pulitano