Outcome Of Pediatric Liver Transplantation And Risk Factors Affecting Overall Survival: Using Two Korean National Registry Data

Background: Children are not just small adults and the results might be somewhat different from the adult LT. The aim of this study is to evaluate the national cohort of pediatric LT patients and analyze the risk factor for mortality. Methods: Two national registry data were used. One is the Korean Network Organ Sharing (KONOS) of the Korea Centers for Disease Control and Prevention, a mandated national registry started in 2000 but the prospective variables are limited. The other one is the Korean Organ Transplantation Registry (KOTRY), a nationwide organ transplantation registration system, includes many variables but started in 2014. Prospectively collected data of 802 pediatric LT patients between February 2000 and December 2015 from KOTRY and 76 pediatric LT patients between May 2014 and December 2017 were retrospectively reviewed. Results: The 1-, 2-, 5-, and 10-year patient survival rates from KONOS data were 89.5%, 87.5%, 85.7%, and 84.8%. The 1-month, 1-, and 2-year patient survival rates from KOTRY were 92.1%, 89.4%, and 87.2%. There was no significant survival difference between the two registry data. KONOS data of 802 children showed that the mean age was 3.9 years and there were 359 (44.8%) male. Biliary atresia was the leading indication (n=357; 44.5%). KOTRY data of 76 children showed that the mean age was 59.4 months and there were 33 (43.4%). Risk factor for mortality was analyzed using KOTRY data. Hepatic artery complication after liver transplantation was the only risk factor of overall mortality (P<0.001). Conclusion: Long-term pediatric patient survival after liver transplantation is satisfactory. More caution is recommended in hepatic artery reconstruction to improve overall survival. References: 1. Lee JG, et al. Donor safety in living donor liver transplantation: The Korean organ transplantation registry study. Liver Transpl. 2017;23:999-1006. 2. Lee KW, et al. Factors affecting graft survival after adult/child split-liver transplantation: Analysis of the UNOS/OPTN data base. Am J Transplant. 2008;8:1186-1196. 3. Kasahara M, et al. Long-term outcomes of pediatric living donor liver transplantation in Japan: An analysis of more than 2200 cases listed in the registry of the japanese liver transplantation society. Am J Transplant. 2013;13:1830-1839.