Late graft loss or death in pediatric liver transplantation: an analysis of the SPLIT database

K. A. Soltys, G. V. Mazariegos, R. H. Squires, R. K. Sindhi, R. Anand, Stephen Dunn, Jerome Manendez, Louise Flynn, Maureen Jonas, Laura Krawczuk, Marielle Christoff, Robert Kane, Harvey Solomon, Erin Phillips, Laurie Ferrer, Thomas Heffron, Jill DePaolo, Todd Pillen, Laurel Davis, John BucuvalasFred Ryckman, Andre Hawkins, Gajra Arya, Michael R. Narkewicz, Ronald J. Sokol, Frederick Karrer, Cara Mark, Kathy Orban-Eller, Abhi Humar, Brenda Durand, Leslie Studenski, Elizabeth Rand, Kathleen Anderer, George Mazariegos, Nydia Chien, Lynn Seward, Paul Atkison, Jay Roden, Naveen Mittal, Lisa Cutright, Grzegorz Telega, Stacee Lerret, Estelle M. Alonso, Joan Lokar, Susan Kelly, Katie Neighbors, Walter S. Andrews, James Daniel, Vicki Fioravanti, Angela Tendick, Anne S. Lindblad, Ravinder Anand, Changhong Song, Karen Martz, Jeff Mitchell, Gladys Fraser, Nicole Hornbeak, Nirali Patel, Jianghang He, Annie Fecteau, Vicky Lee Ng, Maria De Angelis, Andreanne Benidir, Kathleen Schwarz, Paul Colombani, May Kay Alford, Michelle Felix, Robert Jurao, James Eason, John Eshun, Sandra L. Powell, Deborah Freese, Jody Weckwerth, Jean Greseth, Lori Young, Robert Fisher, Michael Akyeampong, Samuel So, William Berquist, Marcia Castillo, Annalie Bula, Sukru Emre, Benjamin Shneider, Nanda Kerkar, Salvador Cuellar, Saul Karpen, Jaymee Mayo, John Goss, Douglas Fishman, Val McLin, Beth Carter, Christine O'Mahony, Thomas Aloia, Donna Garner, Susan Gilmour, Bernadette Dodd, Norman Kneteman, Sue McDiarmid, Susan Fiest, Steven Lobritto, Lesley Smith, Patricia Harren, Kristin Maseda, Fernando Alvarez, Steven Martin, Carol Viau, Ross Shepherd, Jeffrey Lowell, Michelle Nadler, Joel Lavine, Ajai Khanna, Rosemarie Clawson, James Lopez, John Magee, Vicky Shieck, Jeffrey Fair, Steven Lichtman, Ken Andreoni, Joanne Prinzhorn, Valorie Buchholz, Simon Horslen, Melissa Young, Glenn Halff, Stacey Wallace, Joseph Tector, Joel Lim, Jean Molleston, Jean Pearson, Humberto Soriano, Kathleen Falkenstein, Andreas Tzakis, Tomoaki Kato, Debbie Weppler, Lisa Cooper, Monica Gonzalez, Alma Santiago, Munci Kalayoglu, Anthony D'Alessandro, Nissa Erickson, Robert Judo, Stuart Knechtle, Elizabeth Spaith, Regino Gonzalez-Peralta, Marcia Hodik, Stacia McCracken, Philip Rosenthal, Danusia Filipowski, Linda Book, Molly O'Gorman, Cynthia K. Kawai, Lacey Bruschke, Jennifer Kraus, Alan Langnas, Dean Antonson, Jean Botha, Wendy Grant, Debra Sudan, Debb Andersen, Beverly Fleckten, Kris Seipel, J. Michael Millis, Patricia Boone, Dev M. Desai, Sherri Javis, Peter Abt, Tomi Shisler, Cindy Mack

Research output: Contribution to journalArticle

101 Scopus citations

Abstract

Late graft loss (LGL) and late mortality (LM) following liver transplantation (LT) in children were analyzed from the studies of pediatric liver transplantation (SPLIT) database. Univariate and multivariate associations between pre- and postoperative factors and LGL and LM in 872 patients alive with their primary allografts 1 year after LT were reviewed. Thirty-four patients subsequently died (LM) and 35 patients underwent re-LT (LGL). Patients who survive the first posttransplant year had 5-year patient and graft survival rates of 94.2% and 89.2%, respectively. Graft loss after the first year was caused by rejection in 49% of the cases with sequelae of technical complications accounting for an additional 20% of LGL. LT for tumor, steroid resistant rejection, reoperation in the first 30 days and >5 admissions during the first posttransplant year were independently associated with LGL in multivariate analysis. Malignancy, infection, multiple system organ failure and posttransplant lymphoproliferative disease accounted for 61.8% of all late deaths after LT. LT performed for FHF and tumor were associated with LM. Patients who are at or below the mean for weight at the time of transplant were also at an increased risk of dying. Frequent readmission was also found to be associated with LM.

Original languageEnglish (US)
Pages (from-to)2165-2171
Number of pages7
JournalAmerican Journal of Transplantation
Volume7
Issue number9
DOIs
StatePublished - Sep 2007

Keywords

  • Immunosuppression
  • Infection
  • Long-term outcomes
  • Malignancy
  • Patient and graft survival
  • Pediatric liver transplantation

ASJC Scopus subject areas

  • Immunology

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    Soltys, K. A., Mazariegos, G. V., Squires, R. H., Sindhi, R. K., Anand, R., Dunn, S., Manendez, J., Flynn, L., Jonas, M., Krawczuk, L., Christoff, M., Kane, R., Solomon, H., Phillips, E., Ferrer, L., Heffron, T., DePaolo, J., Pillen, T., Davis, L., ... Mack, C. (2007). Late graft loss or death in pediatric liver transplantation: an analysis of the SPLIT database. American Journal of Transplantation, 7(9), 2165-2171. https://doi.org/10.1111/j.1600-6143.2007.01893.x