Liver transplantation for children with Wilson disease: Comparison of outcomes between children and adults

Ronen Arnon, Rachel Annunziato, Michael Schilsky, Tamir Miloh, Asha Willis, Mark Sturdevant, Arnond Sakworawich, Frederick Suchy, Nanda Kerkar

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Liver transplantation (LT) is lifesaving for patients with Wilson disease (WD) presenting with fulminant hepatic failure (FHF) or chronic liver disease (CLD) unresponsive to treatment. Aim: To determine the outcome of LT in pediatric and adult patients with WD. Methods: United Network for Organ Sharing data on LT from 1987 to 2008 were analyzed. Outcomes were compared for patients requiring LT for FHF and CLD after 2002. Multivariate logistic regression was used to determine risk factors for death and graft loss. Results: Of 90867 patients transplanted between 1987 and 2008, 170 children and 400 adults had WD. The one- and five-yr patient survival of children was 90.1% and 89% compared to 88.3% and 86% for adults, p=0.53, 0.34. After 2002, 103 (41 children) were transplanted for FHF and 67 (10 children) for CLD. One- and five-yr patient survival was higher in children transplanted for CLD compared to FHF; 100%, 100% vs. 90%, 87.5% respectively, p=0.30, 0.32. One- and five-yr patient survival was higher in adults transplanted for CLD compared to FHF; 94.7%, 90.1% vs. 90.3%, 89.7%, respectively, p=0.36, 0.88. Encephalopathy, partial graft, and ventilator use were risk factors for death by logistic regression. Conclusion: LT is an excellent treatment option for patients with WD. Patients transplanted for CLD had higher patient survival rates than patients with FHF.

Original languageEnglish (US)
Pages (from-to)E52-E60
JournalClinical Transplantation
Volume25
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Keywords

  • Adult
  • Chronic liver failure
  • Fulminant liver failure
  • Liver transplantation
  • Outcome
  • Pediatric
  • Wilson disease

ASJC Scopus subject areas

  • Transplantation

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