Initial experience of pediatric liver transplantation – An Indian prospective

Abstract

BackgroundLiver transplantation is well established treatment modality worldwide as an effective treatment for end-stage liver disease with only chance of long-term survival. Over the years survival following liver transplantation in pediatric group of patients has improved significantly because of improved diagnostic tools, technical refinements at operation and improved perioperative intensive care management. AimTo assess feasibility and outcome of pediatric liver transplant in India. Materials and methodsFrom Apr 2007 to June 2011, total 15 children underwent liver transplant at our institution and 11 were died while on work up, 6 had Acute Liver Failure (ALF) and rest 5 had Chronic liver disease (CLD). ResultsBiliary atresia was the commonest indication (n = 8). Twelve children had living donor transplants, mothers being the donors in a majority of these. Common surgical complications were vascular problems (n = 3) and bowel perforation (n = 2). Common medical complications included pulmonary sepsis. Overall 1-year survival was 73.4%. All survivors are doing well, have caught up with physical and developmental milestones and are engaged in age appropriate activities. ConclusionsOptimization of patients, nutritional improvement and control of sepsis with early transplant is important predictor of outcome in pediatric population.