2016 - IPTA Fellows Meeting

Mini-Oral Abstract Presentations

14.42 - Pediatric liver transplantation from living donors in cali - colombia

Presenter: Veronica, Botero, Cali, Colombia
Authors: veronica botero, Luis ArmandoLA CaicedoDr, Maria Teresa MT Agudelo, Eliana E Manzi, Jorge J Villegas, Gabriel JJ Echeverry, Oscar O Serrano

Pediatric liver transplantation from living donors in cali - colombia

veronica botero1, Luis Armando LA Caicedo Dr1, Maria Teresa MT Agudelo2, Eliana E Manzi3, Jorge J Villegas1, Gabriel J J Echeverry1, Oscar O Serrano 1.

1Liver trasplantation Unit, Fundación valle de Lili, Cali, Colombia; 2Intensive pediatric Care Unit, Fundación valle de Lili, cali, Colombia; 3Investigation Unit, Fundación valle de Lili, Cali, Colombia

Introduction Starting a pediatric liver transplant program in a developing country is a great challenge, due to technical difficulties and increased morbidity and mortality, and decreased graft survival.   The first liver transplant in children was performed in Fundación Valle del Lili (FVL) in 30 July 1996. During the first year of the program 2 to 7 transplants per year were carried out. Fundación Valle del Lili is a transplant referral center in Cali, South Western of Colombia. We describe here the experience and post-transplant survival in children, during two phases of our program. Methods. All patients transplanted between 31 July 1996 and 30 November 2014, from living donors were included. Follow up was performed every month during the first year and every 3 months afterwards. Phases of the program were defined as follows,  Phase 1 between 1996-2008, and Phase 2 between 2008-2014. Kaplan-Meier and Log Rank test were used for survival analysis. Results. Of the receptors, 41% (90/221) were transplanted from living donors. Six patients required retransplantation, 4 because of thrombosis of the hepatic artery, 1 due to thrombosis of the portal vein and 1 due to biliary duct stricture.  Fifty-two transplant recipients were girls (57%), median weight 7.5 Kilograms (IQR 6.5-10), median age 1 year (IQR 0,8 – 1.8).  Indications for liver transplant were atresia of biliary tract (74%) and fulminant hepatic failure (7%).  Survival after one year in Phase 1 and 2 was 60% (IC95% [43-74]) and 89% (IC95 [76-95]) respectively (p=0,0002), in recipients weighing less than 10 Kilograms survival were 48% (IC95% [27-65]) and 86% (IC95% [69-93]) in Phase 1 and 2 respectively (p<0.0001) . Regarding vascular complications, thrombosis of the hepatic artery was found in 12% of the entire group; although not stastically significant, there was an important reduction in thrombosis of the portal vein (26% vs. 6%).  Survival after 5 years was 89% in phase 2. Conclusions. There was a significant increase in survival, and less vascular complications in phase 2. Better survival could be attributed to greater surgical experience and larger number of patients being transplanted per year.

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