The outcomes of pediatric liver retransplantation from a living donor: a 17-year single-center experience
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Liver retransplantation is the only therapeutic option for patients with graft failure after liver transplantation. The aim of this study is to evaluate the outcomes of pediatric retransplantation from living donor at a single center.
Between December 1998 to August 2015, retransplantation from a living donor was performed for 14 children (<18 years of age) at Kumamoto University Hospital. The characteristics of the retransplantation recipient and the clinicopathological factors between primary transplantation and retransplantation were analyzed to detect the prognostic factors.
In retransplantation, the operative time was longer and the amount of blood loss was greater in comparison to primary transplantation. The 1-, 3-, and 5-year survival rates from the date of retransplantation were 85.7, 85.7, and 78.6%, respectively. The rates of re-laparotomy after primary transplantation, bile leakage and postoperative bleeding after retransplantation were higher than after primary transplantation. Among the three patients who died after retransplantation, the operative time, the rate of re-laparotomy after primary transplantation and the incidence of gastrointestinal complications were higher in comparison to the surviving patients.
Pediatric retransplantation from a living donor is an acceptable procedure that could save the lives of recipients with failing allografts when organs from deceased donors are scarce. To ensure good results, it is essential to make an appropriate assessment of the cardiopulmonary function and the infectious state of the patients before Re-LDLT.
KeywordsPediatric Living donor Liver transplantation Retransplantation
Kohei Miura primarily designed the study, analyzed data, and wrote the manuscript. Keita Shimata, Masaki Honda, and Takashi Kobayashi analyzed data. Seisuke Sakamoto, Toshifumi Wakai, Yasuhiko Sugawara, and Yukihiro Inomata designed the study, analyzed data, and wrote this manuscript. Seisuke Sakamoto is the corresponding author.
Compliance with ethical standards
Conflict of interest
The authors declare no conflicts of interest in association with the present study.
- 11.Broelsch CE, Emond JC, Whitington PF, Thistlethwaite JR, Baker AL, Lichtor JL. Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg. 1990;212:368–75 (discussion 375–7).Google Scholar
- 13.Piper JB, Whitington PF, Woodle ES, Newell KA, Alonso EM, Emond JC, et al. Pediatric liver transplantation at the University of Chicago Hospitals. Clin Transpl. 1992;179–89.Google Scholar
- 16.Strong RW, Lynch SV. Ethical issues in living related donor liver transplantation. Transpl Proc. 1996;28:2366–9.Google Scholar
- 20.The Japanese Liver Transplantation Society. Liver transplantation in Japan (part 1)—registry by the Japanese Liver Transplantation Society (in Japanese with English abstract). Jpn J Transpl. 2013;48:362–8.Google Scholar