Scholarlink

Background <p>Due to the limited data available among middle-income countries, we aimed to determine the characteristics, outcomes and associated factors with death or graft failure in pediatric liver transplantation (LT).</p> Methods <p>Based on the Thai National Liver Transplantation Registry, we analyzed the data of patients under 18 years who underwent LT in Thailand from 2016 to 2024.</p> Results <p>The study included 324 liver transplants (five re-LT), mainly from living donors (246 donors, 75.9%). Among 319 recipients, the most prevalent underlying condition was cirrhosis (274 patients, 85.9%; mostly biliary atresia), followed by acute liver failure (30 patients, 9.4%). In comparison with deceased donor LT, patients who underwent living donor LT (LDLT) reported less waiting time (485 days vs. 146 days, <i>P</i> &lt; 0.001) and a lower pediatric end-stage liver disease (PELD)/model for end-stage liver disease (MELD) score (20.9 vs. 18.1, <i>P</i> = 0.02). The registry revealed 1- and 5-year patient survival rates of 91.7% and 89.6%, respectively. Mortality was noted in 34 patients, with infection as the leading cause of death (19 patients, 55.9%). PELD/MELD score ≥ 20 was associated with death (HR: 2.95; 95% CI: 1.29–6.27) or graft failure (HR: 3.10; 95% CI: 1.37–7.06) in patients who underwent LT due to cirrhosis.</p> Conclusions <p>Pediatric LT in Thailand, mainly LDLT, has a satisfactory outcome. Patients with severe ESLD or high PELD/MELD scores are at risk for death and graft failure after LT. Infection is the most common cause of death. Therefore, timely LT and early effective treatment of infection are crucial.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

National registry on characteristics and outcomes of pediatric liver transplantation in a middle-income country

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月20日

查看全文
  • Songpon Getsuwan,
  • Chutwichai Tovikkai,
  • Chomchanat Tubjareon,
  • Goragoch Gesprasert,
  • Niramol Tantemsapya,
  • Sutha Eiamkulbutr,
  • Voranush Chongsrisawat,
  • Bunthoon Nonthasoot,
  • Chollasak Thirapattaraphan,
  • Sunhawit Junrungsee,
  • Chatmanee Lertudomphonwanit,
  • Ake Pugkhem,
  • Adisorn Lumpaopong,
  • Suporn Treepongkaruna

摘要

Background

Due to the limited data available among middle-income countries, we aimed to determine the characteristics, outcomes and associated factors with death or graft failure in pediatric liver transplantation (LT).

Methods

Based on the Thai National Liver Transplantation Registry, we analyzed the data of patients under 18 years who underwent LT in Thailand from 2016 to 2024.

Results

The study included 324 liver transplants (five re-LT), mainly from living donors (246 donors, 75.9%). Among 319 recipients, the most prevalent underlying condition was cirrhosis (274 patients, 85.9%; mostly biliary atresia), followed by acute liver failure (30 patients, 9.4%). In comparison with deceased donor LT, patients who underwent living donor LT (LDLT) reported less waiting time (485 days vs. 146 days, P < 0.001) and a lower pediatric end-stage liver disease (PELD)/model for end-stage liver disease (MELD) score (20.9 vs. 18.1, P = 0.02). The registry revealed 1- and 5-year patient survival rates of 91.7% and 89.6%, respectively. Mortality was noted in 34 patients, with infection as the leading cause of death (19 patients, 55.9%). PELD/MELD score ≥ 20 was associated with death (HR: 2.95; 95% CI: 1.29–6.27) or graft failure (HR: 3.10; 95% CI: 1.37–7.06) in patients who underwent LT due to cirrhosis.

Conclusions

Pediatric LT in Thailand, mainly LDLT, has a satisfactory outcome. Patients with severe ESLD or high PELD/MELD scores are at risk for death and graft failure after LT. Infection is the most common cause of death. Therefore, timely LT and early effective treatment of infection are crucial.