Outcomes of Liver Transplantation in Infants: A Retrospective Cohort Study

Abstract

ObjectiveLiver transplantation (LT) is a crucial treatment for infants with end-stage liver disease, yet specific data on LT outcomes in infants under 12 months old remain limited. This study aims to present the clinical course and outcomes of infants who underwent LT, assessing the impact of demographic and etiological differences on mortality and survival. MethodsA retrospective analysis was conducted on 64 infants (<12 months) who underwent LT between January 2019 and March 2024. Demographic, clinical, and laboratory data were collected from medical records. LT-specific details, postoperative complications, and survival data were analyzed. ResultsThe median age of the infants was 157 days, with 37 males (57.8%) and 27 females (42.2%). Biliary atresia was the most common diagnosis (85.9%), and seven infants had undergone a previous Kasai procedure. The median PELD score was 15.5. Left lateral segmentectomy was the predominant graft type (60.9%). The median PICU and hospital stays were 5 and 21 days, respectively. Complications occurred in 20 infants (31.3%), with vascular and biliary complication rates both at 12.5%. The overall mortality rate was 17.2%, with early (30-day) and late mortality rates of 6.3% and 10.9%, respectively. The median OS was 204.5 days, and the one-year survival rate was 32.8%. Kaplan-Meier and Log Rank analyses showed no significant impact of sex, age, diagnostic groups, graft type, or surgical complications on OS (p>0.05). ConclusionLT in infants can be performed with acceptable morbidity and mortality rates, particularly with increased experience and standardized protocols.