Pediatric liver transplant program at Hospital Infantil de Mexico Federico Gomez
This article reports the experience of the largest pediatric liver transplant (LT) program in México. Between June 1998 and May 2011, 76 LT were performed in 74 recipients, including 80% cadaveric-whole organ grafts and 20% segmental grafts, 12% of those coming from live donors and 8% from cadaver r...
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| Veröffentlicht in: | Revista de investigacion clinica 2011-09, Vol.63 Suppl 1, p.57-61 |
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| creator | Varela-Fascinetto, Gustavo Hernández-Plata, J Alejandro Nieto-Zermeño, Jaime Alcántar-Fierros, J Manuel Fuentes-García, Victor Castañeda-Martínez, Pedro Valencia-Mayoral, Pedro Salgado-Ramírez, J Manuel |
| description | This article reports the experience of the largest pediatric liver transplant (LT) program in México. Between June 1998 and May 2011, 76 LT were performed in 74 recipients, including 80% cadaveric-whole organ grafts and 20% segmental grafts, 12% of those coming from live donors and 8% from cadaver reduced donors. The most common indication for LT was biliary atresia (43%), followed by metabolic disorders (13%) and fulminant hepatitis (12%). Most of the recipients were infants or toddlers weighing |
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Between June 1998 and May 2011, 76 LT were performed in 74 recipients, including 80% cadaveric-whole organ grafts and 20% segmental grafts, 12% of those coming from live donors and 8% from cadaver reduced donors. The most common indication for LT was biliary atresia (43%), followed by metabolic disorders (13%) and fulminant hepatitis (12%). Most of the recipients were infants or toddlers weighing <15 kg (age range 0.7-17.2 years, weight range 6.5-66 kg), 73% had moderate to severe malnutrition and 72% had multiples surgeries previous to LT. There were 9 cases of hepatic artery thrombosis (11.8%) and 2 portal vein thrombosis (2.6%), however, 8 of these 10 grafts were rescued with early thrombectomy and reanastomosis. All biliary complications (19 cases, 25%) were solved with medical or surgical interventions and did not cause any graft loss. Acute cellular rejection (30 cases, 39%) required thymoglobulin in only 3 cases and chronic rejection (4 cases, 5%) has been retransplanted in 2 cases. CMV infection or reactivation occurred in 30% of cases and easily responded to preemptive therapy. Nine recipients developed postLT neoplasias (7 post-transplant lymphoproliferative disorders, one multivisceral Kaposi sarcoma and one systemic smooth muscle tumor). Five of them responded to decreasing or discontinuing immunosuppression, and 2 are completely tolerant to the graft. The one and five-year patient survival for those LT performed during 2001-2011 was 85 and 75%. The first successful live donor LT in the country was performed in 2001 at this program, as was the first simultaneous liver-kidney transplant in a child. This is the largest and most successful pediatric LT series in the country. Our results demonstrate that pediatric LT is a feasible undertaking in Mexico, with survival rates similar to those of foreign centers.</description><identifier>ISSN: 0034-8376</identifier><identifier>PMID: 22916612</identifier><language>spa</language><publisher>Mexico</publisher><subject>Adolescent ; Child ; Child, Preschool ; Female ; Hospitals ; Humans ; Infant ; Liver Transplantation - adverse effects ; Liver Transplantation - statistics & numerical data ; Male ; Mexico ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology</subject><ispartof>Revista de investigacion clinica, 2011-09, Vol.63 Suppl 1, p.57-61</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22916612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Varela-Fascinetto, Gustavo</creatorcontrib><creatorcontrib>Hernández-Plata, J Alejandro</creatorcontrib><creatorcontrib>Nieto-Zermeño, Jaime</creatorcontrib><creatorcontrib>Alcántar-Fierros, J Manuel</creatorcontrib><creatorcontrib>Fuentes-García, Victor</creatorcontrib><creatorcontrib>Castañeda-Martínez, Pedro</creatorcontrib><creatorcontrib>Valencia-Mayoral, Pedro</creatorcontrib><creatorcontrib>Salgado-Ramírez, J Manuel</creatorcontrib><title>Pediatric liver transplant program at Hospital Infantil de Mexico Federico Gomez</title><title>Revista de investigacion clinica</title><addtitle>Rev Invest Clin</addtitle><description>This article reports the experience of the largest pediatric liver transplant (LT) program in México. Between June 1998 and May 2011, 76 LT were performed in 74 recipients, including 80% cadaveric-whole organ grafts and 20% segmental grafts, 12% of those coming from live donors and 8% from cadaver reduced donors. The most common indication for LT was biliary atresia (43%), followed by metabolic disorders (13%) and fulminant hepatitis (12%). Most of the recipients were infants or toddlers weighing <15 kg (age range 0.7-17.2 years, weight range 6.5-66 kg), 73% had moderate to severe malnutrition and 72% had multiples surgeries previous to LT. There were 9 cases of hepatic artery thrombosis (11.8%) and 2 portal vein thrombosis (2.6%), however, 8 of these 10 grafts were rescued with early thrombectomy and reanastomosis. All biliary complications (19 cases, 25%) were solved with medical or surgical interventions and did not cause any graft loss. Acute cellular rejection (30 cases, 39%) required thymoglobulin in only 3 cases and chronic rejection (4 cases, 5%) has been retransplanted in 2 cases. CMV infection or reactivation occurred in 30% of cases and easily responded to preemptive therapy. Nine recipients developed postLT neoplasias (7 post-transplant lymphoproliferative disorders, one multivisceral Kaposi sarcoma and one systemic smooth muscle tumor). Five of them responded to decreasing or discontinuing immunosuppression, and 2 are completely tolerant to the graft. The one and five-year patient survival for those LT performed during 2001-2011 was 85 and 75%. The first successful live donor LT in the country was performed in 2001 at this program, as was the first simultaneous liver-kidney transplant in a child. This is the largest and most successful pediatric LT series in the country. Our results demonstrate that pediatric LT is a feasible undertaking in Mexico, with survival rates similar to those of foreign centers.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver Transplantation - statistics & numerical data</subject><subject>Male</subject><subject>Mexico</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><issn>0034-8376</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kE1Lw0AYhPeg2Fr9C7JHL4H93vQoxX5AxR70HN5k35WVpIm7G1F_vZHW0wzMwzDMBZkzJlVRSmtm5Dqld8aEENpekZkQS24MF3NyOKALkGNoaBs-MdIc4ZiGFo6ZDrF_i9BRyHTbpyFkaOnu6KcotNQhfcKv0PR0jQ7jn9n0Hf7ckEsPbcLbsy7I6_rxZbUt9s-b3ephXwxc8VxYJq2S0mtlQNXG-9I3GrxXjhummASpHDO115aDRy01aEDnWdnU3irj5ILcn3qnlR8jplx1ITXYTsuxH1PFmdScWbYUE3p3Rse6Q1cNMXQQv6v_F-Qvk6NYNw</recordid><startdate>201109</startdate><enddate>201109</enddate><creator>Varela-Fascinetto, Gustavo</creator><creator>Hernández-Plata, J Alejandro</creator><creator>Nieto-Zermeño, Jaime</creator><creator>Alcántar-Fierros, J Manuel</creator><creator>Fuentes-García, Victor</creator><creator>Castañeda-Martínez, Pedro</creator><creator>Valencia-Mayoral, Pedro</creator><creator>Salgado-Ramírez, J Manuel</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201109</creationdate><title>Pediatric liver transplant program at Hospital Infantil de Mexico Federico Gomez</title><author>Varela-Fascinetto, Gustavo ; Hernández-Plata, J Alejandro ; Nieto-Zermeño, Jaime ; Alcántar-Fierros, J Manuel ; Fuentes-García, Victor ; Castañeda-Martínez, Pedro ; Valencia-Mayoral, Pedro ; Salgado-Ramírez, J Manuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p141t-7037433f546a4b6ff8fc5aff4d160403a34d06bf571afe535a5aedf08cbf746d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>spa</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver Transplantation - statistics & numerical data</topic><topic>Male</topic><topic>Mexico</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Varela-Fascinetto, Gustavo</creatorcontrib><creatorcontrib>Hernández-Plata, J Alejandro</creatorcontrib><creatorcontrib>Nieto-Zermeño, Jaime</creatorcontrib><creatorcontrib>Alcántar-Fierros, J Manuel</creatorcontrib><creatorcontrib>Fuentes-García, Victor</creatorcontrib><creatorcontrib>Castañeda-Martínez, Pedro</creatorcontrib><creatorcontrib>Valencia-Mayoral, Pedro</creatorcontrib><creatorcontrib>Salgado-Ramírez, J Manuel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Revista de investigacion clinica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Varela-Fascinetto, Gustavo</au><au>Hernández-Plata, J Alejandro</au><au>Nieto-Zermeño, Jaime</au><au>Alcántar-Fierros, J Manuel</au><au>Fuentes-García, Victor</au><au>Castañeda-Martínez, Pedro</au><au>Valencia-Mayoral, Pedro</au><au>Salgado-Ramírez, J Manuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric liver transplant program at Hospital Infantil de Mexico Federico Gomez</atitle><jtitle>Revista de investigacion clinica</jtitle><addtitle>Rev Invest Clin</addtitle><date>2011-09</date><risdate>2011</risdate><volume>63 Suppl 1</volume><spage>57</spage><epage>61</epage><pages>57-61</pages><issn>0034-8376</issn><abstract>This article reports the experience of the largest pediatric liver transplant (LT) program in México. Between June 1998 and May 2011, 76 LT were performed in 74 recipients, including 80% cadaveric-whole organ grafts and 20% segmental grafts, 12% of those coming from live donors and 8% from cadaver reduced donors. The most common indication for LT was biliary atresia (43%), followed by metabolic disorders (13%) and fulminant hepatitis (12%). Most of the recipients were infants or toddlers weighing <15 kg (age range 0.7-17.2 years, weight range 6.5-66 kg), 73% had moderate to severe malnutrition and 72% had multiples surgeries previous to LT. There were 9 cases of hepatic artery thrombosis (11.8%) and 2 portal vein thrombosis (2.6%), however, 8 of these 10 grafts were rescued with early thrombectomy and reanastomosis. All biliary complications (19 cases, 25%) were solved with medical or surgical interventions and did not cause any graft loss. Acute cellular rejection (30 cases, 39%) required thymoglobulin in only 3 cases and chronic rejection (4 cases, 5%) has been retransplanted in 2 cases. CMV infection or reactivation occurred in 30% of cases and easily responded to preemptive therapy. Nine recipients developed postLT neoplasias (7 post-transplant lymphoproliferative disorders, one multivisceral Kaposi sarcoma and one systemic smooth muscle tumor). Five of them responded to decreasing or discontinuing immunosuppression, and 2 are completely tolerant to the graft. The one and five-year patient survival for those LT performed during 2001-2011 was 85 and 75%. The first successful live donor LT in the country was performed in 2001 at this program, as was the first simultaneous liver-kidney transplant in a child. This is the largest and most successful pediatric LT series in the country. Our results demonstrate that pediatric LT is a feasible undertaking in Mexico, with survival rates similar to those of foreign centers.</abstract><cop>Mexico</cop><pmid>22916612</pmid><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Child Child, Preschool Female Hospitals Humans Infant Liver Transplantation - adverse effects Liver Transplantation - statistics & numerical data Male Mexico Postoperative Complications - epidemiology Postoperative Complications - etiology |
| title | Pediatric liver transplant program at Hospital Infantil de Mexico Federico Gomez |
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