Junger, Henrik and Knoppke, Birgit and Schurr, Leonhard and Brennfleck, Frank W. and Grothues, Dirk and Melter, Michael and Geissler, Edward K. and Schlitt, Hans J. and Brunner, Stefan M. and Goetz, Markus (2024) Good outcomes after repeated pediatric liver retransplantations: A justified procedure even in times of organ shortage. PEDIATRIC TRANSPLANTATION, 28 (2): e14699. ISSN 1397-3142, 1399-3046
Full text not available from this repository. (Request a copy)Abstract
BackgroundPediatric liver transplantations generally represent advanced surgery for selected patients. In case of acute or chronic graft failure, biliary or vessel complications, a retransplantation (reLT) can be necessary. In these situations massive adhesions, critical patient condition or lack of good vessels for anastomosis often are problematic.MethodsBetween 2008 and 2021, 208 pediatric patients received a liver transplantation at our center. Retrospectively, all cases with at least one retransplantation were identified and stored in a database. Indication, intra- and postoperative course and overall survival (OS) were analyzed.ResultsAltogether 31 patients (14.9%) received a reLT. In 22 cases only one reLT was done, 8 patients received 2 reLTs and 1 patient needed a fourth graft. Median age for primary transplantation, first, second and third reLT was 14 (range: 1-192 months), 60.5 (range: 1-215 months), 58.5 (range: 14-131 months) and 67 months, respectively. Although biliary atresia (42%) and acute liver failure (23%) represented the main indications for the primary liver transplantation, acute and chronic graft failure (1st reLT: 36%, 2nd reLT: 38%), hepatic artery thrombosis (1st reLT: 29%, 2nd reLT: 25%, 3rd reLT: 100%) and biliary complications (1st reLT: 26%, 2nd reLT: 37%) were the most frequent indications for reLT. OS was 81.8% for patients with 1 reLT, 87.5% with 2 reLTs and 100% with 3 reLTs.ConclusionPediatric liver retransplantation is possible with a good outcome even after multiple retransplantations in specialized centers. Nevertheless, careful patient and graft selection, as well as good preoperative conditioning, are essential. Pediatric liver-retransplantation is possible with a good outcome even after repeated retransplantations in specialized centers. Therefore, liver-retransplantation is justified even in times of organ shortage.image
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHILDREN; TRANSPLANTATION; COMPLICATIONS; complications of liver transplantation; liver transplant; pediatric liver transplantation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Kinder- und Jugendmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 Jul 2025 07:59 |
| Last Modified: | 25 Jul 2025 07:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63747 |
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