Studies of pediatric liver transplantation (SPLIT): Year 2000 outcomes

R. Kane, H. Solomon, B. Friedman, T. Heffron, J. DePaulo, R. J. Sokol, F. Karrer, M. R. Narkewicz, K. Orban-Eller, E. S. Maller, N. Higuchi, G. Mazariegos, A. Smith, P. Atkinson, J. Bucuvalas, W. F. Balistreri, F. Ryckman, C. Klekamp, J. Roden, L. D'AmicoE. M. Alonso, R. Superina, P. F. Whitington, P. Mladucky, J. Lokar, W. S. Andrews, J. Daniel, V. Fioravante, A. S. Lindblad, R. Anand, D. Brown, P. Inman, L. Covington, K. Brock, Q. Mekki, A. Fecteau, E. DeLuca, A. Scheiman, P. Colombani, M. K. Alford, B. Wise, H. Shokouh-Amiri, H. P. Grewal, S. L. Powell, D. K. Freese, J. Greseth, R. Fisher, M. Akyeampong, M. Behnke, P. Baliga, T. Johnson, S. Emre, B. Shneider, R. Novak, F. Alvarez, S. Martin, C. Viau, R. Shepherd, M. Nadler, K. Cox, S. So, L. Bush, J. A. Goss, S. Karpen, S. Doster, S. McDiarmid, H. Phillips, Lesley J Smith, A. B. Jones, N. Kneteman, J. Lavine, K. Hall, P. Rosenthal, S. Stritzel, J. M. Millis, S. Kelly, R. P. Gonzalez-Peralta, Jr Langham M., E. Mackay, A. G. Tzakis, R. Romero, B. Miller, D. Weppler, T. Bunchman, R. Holmes, V. Shieck, S. Horslen, B. W. Shaw, D. Andersen, S. Lichtman, B. Kassmann, L. Mieles, R. Quiros, J. Irish-Feltner, M. Kalayoglu, A. D'Alessandro, S. Knechtle, E. Spaith

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Background. Initiated in 1995, the Studies of Pediatric Liver Transplantation (SPLIT) registry database is a cooperative research network of pediatric transplantation centers in the United States and Canada. The primary objectives are to characterize and follow trends in transplant indications, transplantation techniques, and outcomes (e.g., patient/graft survival, rejection, growth parameters, and immunosuppressive therapy.) Methods. As of June 15, 2000, 29 centers registered 1144 patients, 640 of whom received their first liver-only transplant while registered in SPLIT. Patients are followed every 6 months for 2 years and yearly thereafter. Data are submitted to a central coordinating center. Results. One/two-year patient survival and graft loss estimates are 0.85/0.82 and 0.77/0.72, respectively. Risk factors for death include: in ICU at transplant (relative risk (RR) = 2.63, P<0.05) and height/weight deficits of two or more standard deviations (RR= 1.67, P<0.05). Risk factors for graft loss include: in ICU at transplant (RR= 1.77, P<0.05) and receiving a cadaveric split organ compared with a whole organ (RR=2.3, P<0.05). The percentage of patients diagnosed with hepatic a. and portal v. thrombosis were 9.7% and 7%, respectively; 15% had biliary complications within 30 days. At least one re-operation was required in 45%. One/ two-year rejection probability estimates are 0.60/0.66. Tacrolimus, as primary therapy posttransplant, reduces first rejection risk (RR=0.70, P<0.05). Eighty-nine percent of school-aged children are in school full-time, 18 months posttransplant. Conclusions. This report provides one of the first descriptions of characteristics and clinical courses of a multicenter pediatric transplant population. Observations are subject to patient selection biases but are useful for generating hypothesis for future studies.

Original languageEnglish
Pages (from-to)463-476
Number of pages14
JournalTransplantation
Volume72
Issue number3
StatePublished - Aug 15 2001
Externally publishedYes

Fingerprint

Liver Transplantation
Pediatrics
Transplants
Graft Survival
Transplantation
Selection Bias
Liver
Graft Rejection
Tacrolimus
Immunosuppressive Agents
Patient Selection
Canada
Registries
Thrombosis
Databases
Weights and Measures
Therapeutics
Growth
Research
Population

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Kane, R., Solomon, H., Friedman, B., Heffron, T., DePaulo, J., Sokol, R. J., ... Spaith, E. (2001). Studies of pediatric liver transplantation (SPLIT): Year 2000 outcomes. Transplantation, 72(3), 463-476.

Studies of pediatric liver transplantation (SPLIT) : Year 2000 outcomes. / Kane, R.; Solomon, H.; Friedman, B.; Heffron, T.; DePaulo, J.; Sokol, R. J.; Karrer, F.; Narkewicz, M. R.; Orban-Eller, K.; Maller, E. S.; Higuchi, N.; Mazariegos, G.; Smith, A.; Atkinson, P.; Bucuvalas, J.; Balistreri, W. F.; Ryckman, F.; Klekamp, C.; Roden, J.; D'Amico, L.; Alonso, E. M.; Superina, R.; Whitington, P. F.; Mladucky, P.; Lokar, J.; Andrews, W. S.; Daniel, J.; Fioravante, V.; Lindblad, A. S.; Anand, R.; Brown, D.; Inman, P.; Covington, L.; Brock, K.; Mekki, Q.; Fecteau, A.; DeLuca, E.; Scheiman, A.; Colombani, P.; Alford, M. K.; Wise, B.; Shokouh-Amiri, H.; Grewal, H. P.; Powell, S. L.; Freese, D. K.; Greseth, J.; Fisher, R.; Akyeampong, M.; Behnke, M.; Baliga, P.; Johnson, T.; Emre, S.; Shneider, B.; Novak, R.; Alvarez, F.; Martin, S.; Viau, C.; Shepherd, R.; Nadler, M.; Cox, K.; So, S.; Bush, L.; Goss, J. A.; Karpen, S.; Doster, S.; McDiarmid, S.; Phillips, H.; Smith, Lesley J; Jones, A. B.; Kneteman, N.; Lavine, J.; Hall, K.; Rosenthal, P.; Stritzel, S.; Millis, J. M.; Kelly, S.; Gonzalez-Peralta, R. P.; Langham M., Jr; Mackay, E.; Tzakis, A. G.; Romero, R.; Miller, B.; Weppler, D.; Bunchman, T.; Holmes, R.; Shieck, V.; Horslen, S.; Shaw, B. W.; Andersen, D.; Lichtman, S.; Kassmann, B.; Mieles, L.; Quiros, R.; Irish-Feltner, J.; Kalayoglu, M.; D'Alessandro, A.; Knechtle, S.; Spaith, E.

In: Transplantation, Vol. 72, No. 3, 15.08.2001, p. 463-476.

Research output: Contribution to journalArticle

Kane, R, Solomon, H, Friedman, B, Heffron, T, DePaulo, J, Sokol, RJ, Karrer, F, Narkewicz, MR, Orban-Eller, K, Maller, ES, Higuchi, N, Mazariegos, G, Smith, A, Atkinson, P, Bucuvalas, J, Balistreri, WF, Ryckman, F, Klekamp, C, Roden, J, D'Amico, L, Alonso, EM, Superina, R, Whitington, PF, Mladucky, P, Lokar, J, Andrews, WS, Daniel, J, Fioravante, V, Lindblad, AS, Anand, R, Brown, D, Inman, P, Covington, L, Brock, K, Mekki, Q, Fecteau, A, DeLuca, E, Scheiman, A, Colombani, P, Alford, MK, Wise, B, Shokouh-Amiri, H, Grewal, HP, Powell, SL, Freese, DK, Greseth, J, Fisher, R, Akyeampong, M, Behnke, M, Baliga, P, Johnson, T, Emre, S, Shneider, B, Novak, R, Alvarez, F, Martin, S, Viau, C, Shepherd, R, Nadler, M, Cox, K, So, S, Bush, L, Goss, JA, Karpen, S, Doster, S, McDiarmid, S, Phillips, H, Smith, LJ, Jones, AB, Kneteman, N, Lavine, J, Hall, K, Rosenthal, P, Stritzel, S, Millis, JM, Kelly, S, Gonzalez-Peralta, RP, Langham M., J, Mackay, E, Tzakis, AG, Romero, R, Miller, B, Weppler, D, Bunchman, T, Holmes, R, Shieck, V, Horslen, S, Shaw, BW, Andersen, D, Lichtman, S, Kassmann, B, Mieles, L, Quiros, R, Irish-Feltner, J, Kalayoglu, M, D'Alessandro, A, Knechtle, S & Spaith, E 2001, 'Studies of pediatric liver transplantation (SPLIT): Year 2000 outcomes', Transplantation, vol. 72, no. 3, pp. 463-476.
Kane R, Solomon H, Friedman B, Heffron T, DePaulo J, Sokol RJ et al. Studies of pediatric liver transplantation (SPLIT): Year 2000 outcomes. Transplantation. 2001 Aug 15;72(3):463-476.
Kane, R. ; Solomon, H. ; Friedman, B. ; Heffron, T. ; DePaulo, J. ; Sokol, R. J. ; Karrer, F. ; Narkewicz, M. R. ; Orban-Eller, K. ; Maller, E. S. ; Higuchi, N. ; Mazariegos, G. ; Smith, A. ; Atkinson, P. ; Bucuvalas, J. ; Balistreri, W. F. ; Ryckman, F. ; Klekamp, C. ; Roden, J. ; D'Amico, L. ; Alonso, E. M. ; Superina, R. ; Whitington, P. F. ; Mladucky, P. ; Lokar, J. ; Andrews, W. S. ; Daniel, J. ; Fioravante, V. ; Lindblad, A. S. ; Anand, R. ; Brown, D. ; Inman, P. ; Covington, L. ; Brock, K. ; Mekki, Q. ; Fecteau, A. ; DeLuca, E. ; Scheiman, A. ; Colombani, P. ; Alford, M. K. ; Wise, B. ; Shokouh-Amiri, H. ; Grewal, H. P. ; Powell, S. L. ; Freese, D. K. ; Greseth, J. ; Fisher, R. ; Akyeampong, M. ; Behnke, M. ; Baliga, P. ; Johnson, T. ; Emre, S. ; Shneider, B. ; Novak, R. ; Alvarez, F. ; Martin, S. ; Viau, C. ; Shepherd, R. ; Nadler, M. ; Cox, K. ; So, S. ; Bush, L. ; Goss, J. A. ; Karpen, S. ; Doster, S. ; McDiarmid, S. ; Phillips, H. ; Smith, Lesley J ; Jones, A. B. ; Kneteman, N. ; Lavine, J. ; Hall, K. ; Rosenthal, P. ; Stritzel, S. ; Millis, J. M. ; Kelly, S. ; Gonzalez-Peralta, R. P. ; Langham M., Jr ; Mackay, E. ; Tzakis, A. G. ; Romero, R. ; Miller, B. ; Weppler, D. ; Bunchman, T. ; Holmes, R. ; Shieck, V. ; Horslen, S. ; Shaw, B. W. ; Andersen, D. ; Lichtman, S. ; Kassmann, B. ; Mieles, L. ; Quiros, R. ; Irish-Feltner, J. ; Kalayoglu, M. ; D'Alessandro, A. ; Knechtle, S. ; Spaith, E. / Studies of pediatric liver transplantation (SPLIT) : Year 2000 outcomes. In: Transplantation. 2001 ; Vol. 72, No. 3. pp. 463-476.
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title = "Studies of pediatric liver transplantation (SPLIT): Year 2000 outcomes",
abstract = "Background. Initiated in 1995, the Studies of Pediatric Liver Transplantation (SPLIT) registry database is a cooperative research network of pediatric transplantation centers in the United States and Canada. The primary objectives are to characterize and follow trends in transplant indications, transplantation techniques, and outcomes (e.g., patient/graft survival, rejection, growth parameters, and immunosuppressive therapy.) Methods. As of June 15, 2000, 29 centers registered 1144 patients, 640 of whom received their first liver-only transplant while registered in SPLIT. Patients are followed every 6 months for 2 years and yearly thereafter. Data are submitted to a central coordinating center. Results. One/two-year patient survival and graft loss estimates are 0.85/0.82 and 0.77/0.72, respectively. Risk factors for death include: in ICU at transplant (relative risk (RR) = 2.63, P<0.05) and height/weight deficits of two or more standard deviations (RR= 1.67, P<0.05). Risk factors for graft loss include: in ICU at transplant (RR= 1.77, P<0.05) and receiving a cadaveric split organ compared with a whole organ (RR=2.3, P<0.05). The percentage of patients diagnosed with hepatic a. and portal v. thrombosis were 9.7{\%} and 7{\%}, respectively; 15{\%} had biliary complications within 30 days. At least one re-operation was required in 45{\%}. One/ two-year rejection probability estimates are 0.60/0.66. Tacrolimus, as primary therapy posttransplant, reduces first rejection risk (RR=0.70, P<0.05). Eighty-nine percent of school-aged children are in school full-time, 18 months posttransplant. Conclusions. This report provides one of the first descriptions of characteristics and clinical courses of a multicenter pediatric transplant population. Observations are subject to patient selection biases but are useful for generating hypothesis for future studies.",
author = "R. Kane and H. Solomon and B. Friedman and T. Heffron and J. DePaulo and Sokol, {R. J.} and F. Karrer and Narkewicz, {M. R.} and K. Orban-Eller and Maller, {E. S.} and N. Higuchi and G. Mazariegos and A. Smith and P. Atkinson and J. Bucuvalas and Balistreri, {W. F.} and F. Ryckman and C. Klekamp and J. Roden and L. D'Amico and Alonso, {E. M.} and R. Superina and Whitington, {P. F.} and P. Mladucky and J. Lokar and Andrews, {W. S.} and J. Daniel and V. Fioravante and Lindblad, {A. S.} and R. Anand and D. Brown and P. Inman and L. Covington and K. Brock and Q. Mekki and A. Fecteau and E. DeLuca and A. Scheiman and P. Colombani and Alford, {M. K.} and B. Wise and H. Shokouh-Amiri and Grewal, {H. P.} and Powell, {S. L.} and Freese, {D. K.} and J. Greseth and R. Fisher and M. Akyeampong and M. Behnke and P. Baliga and T. Johnson and S. Emre and B. Shneider and R. Novak and F. Alvarez and S. Martin and C. Viau and R. Shepherd and M. Nadler and K. Cox and S. So and L. Bush and Goss, {J. A.} and S. Karpen and S. Doster and S. McDiarmid and H. Phillips and Smith, {Lesley J} and Jones, {A. B.} and N. Kneteman and J. Lavine and K. Hall and P. Rosenthal and S. Stritzel and Millis, {J. M.} and S. Kelly and Gonzalez-Peralta, {R. P.} and {Langham M.}, Jr and E. Mackay and Tzakis, {A. G.} and R. Romero and B. Miller and D. Weppler and T. Bunchman and R. Holmes and V. Shieck and S. Horslen and Shaw, {B. W.} and D. Andersen and S. Lichtman and B. Kassmann and L. Mieles and R. Quiros and J. Irish-Feltner and M. Kalayoglu and A. D'Alessandro and S. Knechtle and E. Spaith",
year = "2001",
month = "8",
day = "15",
language = "English",
volume = "72",
pages = "463--476",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
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TY - JOUR

T1 - Studies of pediatric liver transplantation (SPLIT)

T2 - Year 2000 outcomes

AU - Kane, R.

AU - Solomon, H.

AU - Friedman, B.

AU - Heffron, T.

AU - DePaulo, J.

AU - Sokol, R. J.

AU - Karrer, F.

AU - Narkewicz, M. R.

AU - Orban-Eller, K.

AU - Maller, E. S.

AU - Higuchi, N.

AU - Mazariegos, G.

AU - Smith, A.

AU - Atkinson, P.

AU - Bucuvalas, J.

AU - Balistreri, W. F.

AU - Ryckman, F.

AU - Klekamp, C.

AU - Roden, J.

AU - D'Amico, L.

AU - Alonso, E. M.

AU - Superina, R.

AU - Whitington, P. F.

AU - Mladucky, P.

AU - Lokar, J.

AU - Andrews, W. S.

AU - Daniel, J.

AU - Fioravante, V.

AU - Lindblad, A. S.

AU - Anand, R.

AU - Brown, D.

AU - Inman, P.

AU - Covington, L.

AU - Brock, K.

AU - Mekki, Q.

AU - Fecteau, A.

AU - DeLuca, E.

AU - Scheiman, A.

AU - Colombani, P.

AU - Alford, M. K.

AU - Wise, B.

AU - Shokouh-Amiri, H.

AU - Grewal, H. P.

AU - Powell, S. L.

AU - Freese, D. K.

AU - Greseth, J.

AU - Fisher, R.

AU - Akyeampong, M.

AU - Behnke, M.

AU - Baliga, P.

AU - Johnson, T.

AU - Emre, S.

AU - Shneider, B.

AU - Novak, R.

AU - Alvarez, F.

AU - Martin, S.

AU - Viau, C.

AU - Shepherd, R.

AU - Nadler, M.

AU - Cox, K.

AU - So, S.

AU - Bush, L.

AU - Goss, J. A.

AU - Karpen, S.

AU - Doster, S.

AU - McDiarmid, S.

AU - Phillips, H.

AU - Smith, Lesley J

AU - Jones, A. B.

AU - Kneteman, N.

AU - Lavine, J.

AU - Hall, K.

AU - Rosenthal, P.

AU - Stritzel, S.

AU - Millis, J. M.

AU - Kelly, S.

AU - Gonzalez-Peralta, R. P.

AU - Langham M., Jr

AU - Mackay, E.

AU - Tzakis, A. G.

AU - Romero, R.

AU - Miller, B.

AU - Weppler, D.

AU - Bunchman, T.

AU - Holmes, R.

AU - Shieck, V.

AU - Horslen, S.

AU - Shaw, B. W.

AU - Andersen, D.

AU - Lichtman, S.

AU - Kassmann, B.

AU - Mieles, L.

AU - Quiros, R.

AU - Irish-Feltner, J.

AU - Kalayoglu, M.

AU - D'Alessandro, A.

AU - Knechtle, S.

AU - Spaith, E.

PY - 2001/8/15

Y1 - 2001/8/15

N2 - Background. Initiated in 1995, the Studies of Pediatric Liver Transplantation (SPLIT) registry database is a cooperative research network of pediatric transplantation centers in the United States and Canada. The primary objectives are to characterize and follow trends in transplant indications, transplantation techniques, and outcomes (e.g., patient/graft survival, rejection, growth parameters, and immunosuppressive therapy.) Methods. As of June 15, 2000, 29 centers registered 1144 patients, 640 of whom received their first liver-only transplant while registered in SPLIT. Patients are followed every 6 months for 2 years and yearly thereafter. Data are submitted to a central coordinating center. Results. One/two-year patient survival and graft loss estimates are 0.85/0.82 and 0.77/0.72, respectively. Risk factors for death include: in ICU at transplant (relative risk (RR) = 2.63, P<0.05) and height/weight deficits of two or more standard deviations (RR= 1.67, P<0.05). Risk factors for graft loss include: in ICU at transplant (RR= 1.77, P<0.05) and receiving a cadaveric split organ compared with a whole organ (RR=2.3, P<0.05). The percentage of patients diagnosed with hepatic a. and portal v. thrombosis were 9.7% and 7%, respectively; 15% had biliary complications within 30 days. At least one re-operation was required in 45%. One/ two-year rejection probability estimates are 0.60/0.66. Tacrolimus, as primary therapy posttransplant, reduces first rejection risk (RR=0.70, P<0.05). Eighty-nine percent of school-aged children are in school full-time, 18 months posttransplant. Conclusions. This report provides one of the first descriptions of characteristics and clinical courses of a multicenter pediatric transplant population. Observations are subject to patient selection biases but are useful for generating hypothesis for future studies.

AB - Background. Initiated in 1995, the Studies of Pediatric Liver Transplantation (SPLIT) registry database is a cooperative research network of pediatric transplantation centers in the United States and Canada. The primary objectives are to characterize and follow trends in transplant indications, transplantation techniques, and outcomes (e.g., patient/graft survival, rejection, growth parameters, and immunosuppressive therapy.) Methods. As of June 15, 2000, 29 centers registered 1144 patients, 640 of whom received their first liver-only transplant while registered in SPLIT. Patients are followed every 6 months for 2 years and yearly thereafter. Data are submitted to a central coordinating center. Results. One/two-year patient survival and graft loss estimates are 0.85/0.82 and 0.77/0.72, respectively. Risk factors for death include: in ICU at transplant (relative risk (RR) = 2.63, P<0.05) and height/weight deficits of two or more standard deviations (RR= 1.67, P<0.05). Risk factors for graft loss include: in ICU at transplant (RR= 1.77, P<0.05) and receiving a cadaveric split organ compared with a whole organ (RR=2.3, P<0.05). The percentage of patients diagnosed with hepatic a. and portal v. thrombosis were 9.7% and 7%, respectively; 15% had biliary complications within 30 days. At least one re-operation was required in 45%. One/ two-year rejection probability estimates are 0.60/0.66. Tacrolimus, as primary therapy posttransplant, reduces first rejection risk (RR=0.70, P<0.05). Eighty-nine percent of school-aged children are in school full-time, 18 months posttransplant. Conclusions. This report provides one of the first descriptions of characteristics and clinical courses of a multicenter pediatric transplant population. Observations are subject to patient selection biases but are useful for generating hypothesis for future studies.

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UR - http://www.scopus.com/inward/citedby.url?scp=0035881426&partnerID=8YFLogxK

M3 - Article

C2 - 11502977

AN - SCOPUS:0035881426

VL - 72

SP - 463

EP - 476

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 3

ER -