User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

Living-related versus deceased donor pediatric liver transplantation: a multivariate analysis of technical and immunological complications in 235 recipients.

Primary tabs

Bourdeaux, Christophe [UCL] Darwish, A Jamart, Jacques [UCL] Tri, T T Janssen, M. Lerut, Jan [UCL] Otte, Jean-Bernard [UCL] Sokal, Etienne [UCL] de Ville de Goyet, Jean [UCL] Reding, Raymond [UCL]

Timely access to a living donor (LD) reduced pretransplant mortality in pediatric liver transplantation (LT). We hypothesized that this strategy may provide better posttransplant outcome. Between July 1993 and April 2002, 235 children received a primary LT from a LD (n = 100) or a deceased donor (DD) (n = 135). Demographic, surgical and immunological variables were compared, and respective impact on posttransplant complications was studied using a multivariate analysis. Five-year patient survival rates were 92% and 85% for groups LD and DD, respectively (p = 0.181), the corresponding graft survival rates being 89% and 77% (p = 0.033). At multivariate analysis: (1) type of donor (DD) was correlated with higher rate of artery thrombosis (p < 0.012); (2) biliary complication rate at 5 years was 29% and 23% for groups LD and DD, respectively (p = 0.451); (3) lower acute rejection incidence could be correlated with type of donor (DD) (p = 0.001), and immunosuppressive therapy (tacrolimus) (p < 0.001). We conclude that (1) according to the multivariate analysis, LT with LD provided similar patient and graft outcome, when compared to DD; (2) a higher rate of artery thrombosis and a lower rate of rejection were observed in group DD; (3) this study confirms the efficacy of tacrolimus for immunoprophylaxis, whatever the type of organ donor is.

Document type Article de périodique (Journal article) – Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
Access type Accès restreint
Publication date 2007
Journal information "American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons" - Vol. 7, no. 2, p. 440-7 (2007)
Peer reviewed yes
issn 1600-6135
Publication status Publié
Affiliations UCL - MD/CHIR - Département de chirurgie
UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie
UCL - (SLuc) Service de chirurgie et transplantation abdominale
UCL - (MGD) Unité de support scientifique
UCL - (SLuc) Service de gastro-entérologie et hépatologie pédiatrique
UCL - (SLuc) Centre de thérapie tissulaire et cellulaire
UCL - (SLuc) Centre de pathologie anorectale de l'enfant
MESH Subject Adolescent ; Child ; Child, Preschool ; Female ; Graft Rejection - immunology - mortality - prevention & control ; Humans ; Immunosuppressive Agents - therapeutic use ; Infant ; Liver Transplantation - adverse effects - immunology - mortality ; Living Donors ; Male ; Multivariate Analysis ; Retrospective Studies ; Survival Rate ; Tacrolimus - therapeutic use ; Treatment Outcome
Links
  1. National Institutes of Health consensus development conference statement, Hepatology, 4, 107 (1984)
  2. McDiarmid S.V, Current status of liver transplantation in children, 10.1016/s0031-3955(03)00150-0
  3. de Ville de Goyet Jean, Hausleithner Victoria, Reding Raymond, Lerut Jan, Jamssem Magda, Otte Jean-Bernard, Impact Of Innovative Techniques On The Waiting List And Results In Pediatric Liver Transplantation : , 10.1097/00007890-199311000-00016
  4. Raia Silvano, Nery JoséRoberto, Mies Sérgio, LIVER TRANSPLANTATION FROM LIVE DONORS, 10.1016/s0140-6736(89)92101-6
  5. Strong RW, N Engl J Med, 322, 1505 (1990)
  6. Reding Raymond, de Ville de Goyet Jean, Delbeke Isabelle, Sokal Etienne, Jamart Jacques, Janssen Magda, Otte Jean-Bernard, Pediatric liver transplantation with cadaveric or living related donors: Comparative results in 90 elective recipients of primary grafts, 10.1016/s0022-3476(99)70450-6
  7. Darwish Ahmed A., Bourdeaux Christophe, Kader Hesham A., Janssen Magda, Sokal Etienne, Lerut Jan, Ciccarelli Olga, Veyckemans Francis, Otte Jean-Bernard, Goyet Jean de Ville de, Reding Raymond, Pediatric liver transplantation using left hepatic segments from living related donors: Surgical experience in 100 recipients at Saint-Luc University Clinics, 10.1111/j.1399-3046.2005.00477.x
  8. Otte Jean-Bernard, Janssen Magda, Rosati Maria-Rita, Gonze Dominique, Parental experience with living-related donor liver transplantation, 10.1111/j.1399-3046.2004.00205.x
  9. Reding Raymond, Is It Right to Promote Living Donor Liver Transplantation for Fulminant Hepatic Failure in Pediatric Recipients?, 10.1111/j.1600-6143.2005.00915.x
  10. Otte J. B., de Villede Goyet J., Reding R., Van Obbergh L., Veyckemans F., Carlier M. A., De Kock M., Clement de Clety S., Clapuyt P., Sokal E., Lerut J., Delbeke I., Dierick V., Janssen M., Rosati R., Libert F., Pediatric liver transplantation: from the full-size liver graft to reduced, split, and living related liver transplantation, 10.1007/s003830050328
  11. Mart??nez J. A., Rigamonti W., Rahier J., Gigi J., Lerut J., de Ville de Goyet J., Otte J. B., Reding R., PRESERVED VASCULAR HOMOGRAFT FOR REVASCULARIZATION OF PEDIATRIC LIVER TRANSPLANT1 : A Clinical, Histological, and Bacteriological Study, 10.1097/00007890-199909150-00013
  12. de Goyet Jean de Ville, Gibbs Paul, Clapuyt Philippe, Reding Raymond, Sokal Etienne M., Otte Jean-Bernard, ORIGINAL EXTRAHILAR APPROACH FOR HEPATIC PORTAL REVASCULARIZATION AND RELIEF OF EXTRAHEPATIC PORTAL HYPERTENSION RELATED TO LATE PORTAL VEIN THROMBOSIS AFTER PEDIATRIC LIVER TRANSPLANTATION : Long-Term Results, 10.1097/00007890-199607150-00015
  13. Reding R, Acta Gastroenterol Belg, 67, 176 (2004)
  14. Reding Raymond, Gras Jérémie, Sokal Etienne, Otte Jean-Bernard, Davies Hugh FS, Steroid-free liver transplantation in children, 10.1016/s0140-6736(03)15104-5
  15. Hubscher SG, J Clin Pathol, 38, 1366 (1985)
  16. McDiarmid Sue V., Anand Ravinder, Lindblad Anne S., Development of a pediatric end-stage liver disease score to predict poor outcome in children awaiting liver transplantation1 : , 10.1097/00007890-200207270-00006
  17. Bourdeaux Christophe, Tri Tran Thanh, Gras J??r??mie, Sokal Etienne, Otte Jean-Bernard, de Ville de Goyet Jean, Reding Raymond, PELD Score and Posttransplant Outcome in Pediatric Liver Transplantation: A Retrospective Study of 100 Recipients : , 10.1097/00007890-200505150-00060
  18. Evrard Veerle, Otte Jean-Bernard, Sokal Etienne, Rochet Jean-Stéphan, Haccourt Fabian, Gennari Fabrizio, Latinne Dominique, Jamart Jacques, Reding Raymond, Impact of Surgical and Immunological Parameters in Pediatric Liver Transplantation : A Multivariate Analysis in 500 Consecutive Recipients of Primary Grafts, 10.1097/01.sla.0000108681.24374.02
  19. Austin Mary T., Survival After Pediatric Liver Transplantation : Why Does Living Donation Offer an Advantage?, 10.1001/archsurg.140.5.465
  20. Sweet S. C., Wong H.-H., Webber S. A., Horslen S., Guidinger M. K., Fine R. N., Magee J. C., Pediatric Transplantation in the United States, 1995-2004 : Pediatric Transplantation, 1995-2004, 10.1111/j.1600-6143.2006.01271.x
  21. Mor E, Transplantation, 56, 1399 (1993)
  22. Reding Raymond, Wallemacq Pierre, Moulin Didier, Manicourt Daniel, Lambotte Luc, Jamart Jacques, Sokal Etienne, de Ville de Goyet Jean, Otte Jean-Bernard, EARLY HEPATOCYTE, ENDOTHELIAL, AND BILE DUCT CELL INJURY AFTER PEDIATRIC LIVER TRANSPLANTATION FROM CADAVERIC OR LIVING-RELATED DONORS : , 10.1097/00007890-199803150-00014
  23. Kling K., Lau H., Colombani P., Biliary complications of living related pediatric liver transplant patients, 10.1046/j.1399-3046.2003.00127.x
  24. OSWARI HANIFAH, LYNCH STEPHEN V, FAWCETT JONATHAN, STRONG RUSSELL W, EE LOOI C, Outcomes of split versus reduced-size grafts in pediatric liver transplantation, 10.1111/j.1440-1746.2005.03926.x
  25. Francavilla Ruggiero, Hadzic Nedim, Underhill James, Heaton Nigel, Rela Mohamed, Mieli-Vergani Giorgina, Donaldson Peter, ROLE OF HLA COMPATIBILITY IN PEDIATRIC LIVER TRANSPLANTATION : , 10.1097/00007890-199807150-00009
  26. Kasahara Mureo, Kiuchi Tetsuya, Uryuhara Kenji, Uemoto Shinji, Fujimoto Yasuhiro, Ogura Yasuhiro, Oike Fumitaka, Kaihara Satoshi, Egawa Hiroto, Tanaka Koichi, Role of HLA compatibility in pediatric living-related liver transplantation1 : , 10.1097/00007890-200210270-00020
  27. Toyoki Yoshikazu, Renz John F., Mudge Christine, Ascher Nancy L., Roberts John P., Rosenthal Philip, Allograft rejection in pediatric liver transplantation: Comparison between cadaveric and living related donors, 10.1034/j.1399-3046.2002.02013.x
  28. McEnery PT, N Engl J Med, 326, 1727 (1992)
  29. Kelly Deirdre, Jara Paloma, Rodeck Burkhard, Lykavieris Panayotis, Burdelski Martin, Becker Michael, Gridelli Bruno, Boillot Olivier, Manzanares Javier, Reding Raymond, Tacrolimus and steroids versus ciclosporin microemulsion, steroids, and azathioprine in children undergoing liver transplantation: randomised European multicentre trial, 10.1016/s0140-6736(04)17060-8
Bibliographic reference Bourdeaux, Christophe ; Darwish, A ; Jamart, Jacques ; Tri, T T ; Janssen, M. ; et. al. Living-related versus deceased donor pediatric liver transplantation: a multivariate analysis of technical and immunological complications in 235 recipients.. In: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, Vol. 7, no. 2, p. 440-7 (2007)
Permanent URL http://hdl.handle.net/2078.1/10802