Comparison of Outcome after Pediatric Liver Transplantation for Metabolic Diseases and Biliary Atresia

Summary Metabolic diseases (MD) are the second largest indication group for orthotopic liver transplantation (OLTx) in children after biliary atresia (BA). A better outcome after transplantation can be expected because of a better pretransplant condition and the absence of previous abdominal surgery...

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Veröffentlicht in:European journal of pediatric surgery 2001-02, Vol.11 (1), p.28-35
Hauptverfasser: Peeters, P. M. J. G., Sieders, E., De Jong, K. P., Bijleveld, C. M. A., Hendriks, H. G. D., Ten Vergert, E. M., Slooff, M. J. H.
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container_end_page 35
container_issue 1
container_start_page 28
container_title European journal of pediatric surgery
container_volume 11
creator Peeters, P. M. J. G.
Sieders, E.
De Jong, K. P.
Bijleveld, C. M. A.
Hendriks, H. G. D.
Ten Vergert, E. M.
Slooff, M. J. H.
description Summary Metabolic diseases (MD) are the second largest indication group for orthotopic liver transplantation (OLTx) in children after biliary atresia (BA). A better outcome after transplantation can be expected because of a better pretransplant condition and the absence of previous abdominal surgery. To prove this statement, patient survival, graft survival, and morbidity were compared between a group of 24 for MD and 52 for BA consecutively transplanted children. The actuarial one- and five-year patient survival rates for MD were 96 % and 84 %, and for BA 84 % and 70 %, respectively (p logrank test = 0.17). Three MD children (13 %) and 15 BA children (29 %) died. The actuarial one- and five-year graft survival rates for MD were 75 % and 58 %, and for BA 75 % and 64 %, respectively (p logrank test = 0.76). Seven MD children (29 %) and 11 BA children (21 %) were retransplanted. Postoperative bleeding and gastrointestinal complications occurred less frequent (4 % vs. 18 % and 4 % vs. 14 %, respectively), whereas biliary complications, viral infections, and acute rejection occurred more frequently (38 % vs. 21 %, 29 % vs. 15 %, and 50 % vs. 37 %, respectively) in MD children. The difference in the incidence of the various postoperative complications between both groups was not statistically significant. The mean ICU and ventilator stay was 7.5 and four days, respectively, in MD children and 16 and 10 days, respectively, in BA children (p = ns). The mean infection, complication, intervention, and retransplantation rate was equal in both groups. CONCLUSION: Mortality and morbidity after pediatric liver transplantation for MD and BA are not different despite the better starting point for children with MD.
doi_str_mv 10.1055/s-2001-12188
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M. J. G. ; Sieders, E. ; De Jong, K. P. ; Bijleveld, C. M. A. ; Hendriks, H. G. D. ; Ten Vergert, E. M. ; Slooff, M. J. H.</creator><creatorcontrib>Peeters, P. M. J. G. ; Sieders, E. ; De Jong, K. P. ; Bijleveld, C. M. A. ; Hendriks, H. G. D. ; Ten Vergert, E. M. ; Slooff, M. J. H.</creatorcontrib><description>Summary Metabolic diseases (MD) are the second largest indication group for orthotopic liver transplantation (OLTx) in children after biliary atresia (BA). A better outcome after transplantation can be expected because of a better pretransplant condition and the absence of previous abdominal surgery. To prove this statement, patient survival, graft survival, and morbidity were compared between a group of 24 for MD and 52 for BA consecutively transplanted children. The actuarial one- and five-year patient survival rates for MD were 96 % and 84 %, and for BA 84 % and 70 %, respectively (p logrank test = 0.17). Three MD children (13 %) and 15 BA children (29 %) died. The actuarial one- and five-year graft survival rates for MD were 75 % and 58 %, and for BA 75 % and 64 %, respectively (p logrank test = 0.76). Seven MD children (29 %) and 11 BA children (21 %) were retransplanted. Postoperative bleeding and gastrointestinal complications occurred less frequent (4 % vs. 18 % and 4 % vs. 14 %, respectively), whereas biliary complications, viral infections, and acute rejection occurred more frequently (38 % vs. 21 %, 29 % vs. 15 %, and 50 % vs. 37 %, respectively) in MD children. The difference in the incidence of the various postoperative complications between both groups was not statistically significant. The mean ICU and ventilator stay was 7.5 and four days, respectively, in MD children and 16 and 10 days, respectively, in BA children (p = ns). The mean infection, complication, intervention, and retransplantation rate was equal in both groups. CONCLUSION: Mortality and morbidity after pediatric liver transplantation for MD and BA are not different despite the better starting point for children with MD.</description><identifier>ISSN: 0939-7248</identifier><identifier>EISSN: 1439-359X</identifier><identifier>DOI: 10.1055/s-2001-12188</identifier><identifier>PMID: 11370979</identifier><language>eng</language><publisher>Stuttgart: Thieme</publisher><subject>Biliary Atresia - mortality ; Biliary Atresia - surgery ; Biological and medical sciences ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Length of Stay ; Liver Transplantation ; Liver, biliary tract, pancreas, portal circulation, spleen ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Malformations ; Medical sciences ; Metabolic Diseases - mortality ; Metabolic Diseases - surgery ; Original Article ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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M. J. G.</creatorcontrib><creatorcontrib>Sieders, E.</creatorcontrib><creatorcontrib>De Jong, K. P.</creatorcontrib><creatorcontrib>Bijleveld, C. M. A.</creatorcontrib><creatorcontrib>Hendriks, H. G. D.</creatorcontrib><creatorcontrib>Ten Vergert, E. M.</creatorcontrib><creatorcontrib>Slooff, M. J. H.</creatorcontrib><title>Comparison of Outcome after Pediatric Liver Transplantation for Metabolic Diseases and Biliary Atresia</title><title>European journal of pediatric surgery</title><addtitle>Eur J Pediatr Surg</addtitle><description>Summary Metabolic diseases (MD) are the second largest indication group for orthotopic liver transplantation (OLTx) in children after biliary atresia (BA). A better outcome after transplantation can be expected because of a better pretransplant condition and the absence of previous abdominal surgery. To prove this statement, patient survival, graft survival, and morbidity were compared between a group of 24 for MD and 52 for BA consecutively transplanted children. The actuarial one- and five-year patient survival rates for MD were 96 % and 84 %, and for BA 84 % and 70 %, respectively (p logrank test = 0.17). Three MD children (13 %) and 15 BA children (29 %) died. The actuarial one- and five-year graft survival rates for MD were 75 % and 58 %, and for BA 75 % and 64 %, respectively (p logrank test = 0.76). Seven MD children (29 %) and 11 BA children (21 %) were retransplanted. Postoperative bleeding and gastrointestinal complications occurred less frequent (4 % vs. 18 % and 4 % vs. 14 %, respectively), whereas biliary complications, viral infections, and acute rejection occurred more frequently (38 % vs. 21 %, 29 % vs. 15 %, and 50 % vs. 37 %, respectively) in MD children. The difference in the incidence of the various postoperative complications between both groups was not statistically significant. The mean ICU and ventilator stay was 7.5 and four days, respectively, in MD children and 16 and 10 days, respectively, in BA children (p = ns). The mean infection, complication, intervention, and retransplantation rate was equal in both groups. CONCLUSION: Mortality and morbidity after pediatric liver transplantation for MD and BA are not different despite the better starting point for children with MD.</description><subject>Biliary Atresia - mortality</subject><subject>Biliary Atresia - surgery</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Liver Transplantation</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Malformations</subject><subject>Medical sciences</subject><subject>Metabolic Diseases - mortality</subject><subject>Metabolic Diseases - surgery</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Treatment Outcome</subject><issn>0939-7248</issn><issn>1439-359X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkE1P3DAQhi3UChbKjXPlQ9VLm9YfceIcYUsp0lb0QKXeLMcZC6MkXjwOUv99DbtSOXCaGemZd0YPIWecfeFMqa9YCcZ4xQXX-oCseC27SqruzxuyYl3pW1HrI3KMeF-wuhPskBxxLlvWtd2K-HWctjYFjDONnt4s2cUJqPUZEv0FQ7A5BUc34bHMt8nOuB3tnG0OZcHHRH9Ctn0cC_MtIFgEpHYe6EUYg01_6XlOgMG-I2-9HRFO9_WE_P5-ebv-UW1urq7X55vKSSVypUQDvG65V9D0g9WsbuzAOPQcuLND7aGRTLN26GrtoQUnuFLQa9-3vBmklCfk4y53m-LDApjNFNDBWH6GuKBpmW6ErLsCft6BLkXEBN5sU5jKx4Yz8-TVoHnyap69Fvz9PnfpJxj-w3uRBfiwByw6O_piygV8ESq0kqJgn3ZYvgswgbmPS5qLkNev_gOZNY5L</recordid><startdate>20010201</startdate><enddate>20010201</enddate><creator>Peeters, P. M. J. G.</creator><creator>Sieders, E.</creator><creator>De Jong, K. P.</creator><creator>Bijleveld, C. M. A.</creator><creator>Hendriks, H. G. D.</creator><creator>Ten Vergert, E. M.</creator><creator>Slooff, M. J. H.</creator><general>Thieme</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010201</creationdate><title>Comparison of Outcome after Pediatric Liver Transplantation for Metabolic Diseases and Biliary Atresia</title><author>Peeters, P. M. J. G. ; Sieders, E. ; De Jong, K. P. ; Bijleveld, C. M. A. ; Hendriks, H. G. D. ; Ten Vergert, E. M. ; Slooff, M. J. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-526e1471f5e6bda8046ad01eb1e1cad4fe630807d948fe7ec2155eb8fb716d333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Biliary Atresia - mortality</topic><topic>Biliary Atresia - surgery</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Liver Transplantation</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Malformations</topic><topic>Medical sciences</topic><topic>Metabolic Diseases - mortality</topic><topic>Metabolic Diseases - surgery</topic><topic>Original Article</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peeters, P. M. J. G.</creatorcontrib><creatorcontrib>Sieders, E.</creatorcontrib><creatorcontrib>De Jong, K. P.</creatorcontrib><creatorcontrib>Bijleveld, C. M. A.</creatorcontrib><creatorcontrib>Hendriks, H. G. D.</creatorcontrib><creatorcontrib>Ten Vergert, E. M.</creatorcontrib><creatorcontrib>Slooff, M. J. 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H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Outcome after Pediatric Liver Transplantation for Metabolic Diseases and Biliary Atresia</atitle><jtitle>European journal of pediatric surgery</jtitle><addtitle>Eur J Pediatr Surg</addtitle><date>2001-02-01</date><risdate>2001</risdate><volume>11</volume><issue>1</issue><spage>28</spage><epage>35</epage><pages>28-35</pages><issn>0939-7248</issn><eissn>1439-359X</eissn><abstract>Summary Metabolic diseases (MD) are the second largest indication group for orthotopic liver transplantation (OLTx) in children after biliary atresia (BA). A better outcome after transplantation can be expected because of a better pretransplant condition and the absence of previous abdominal surgery. To prove this statement, patient survival, graft survival, and morbidity were compared between a group of 24 for MD and 52 for BA consecutively transplanted children. 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The mean infection, complication, intervention, and retransplantation rate was equal in both groups. CONCLUSION: Mortality and morbidity after pediatric liver transplantation for MD and BA are not different despite the better starting point for children with MD.</abstract><cop>Stuttgart</cop><pub>Thieme</pub><pmid>11370979</pmid><doi>10.1055/s-2001-12188</doi><tpages>8</tpages></addata></record>
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subjects Biliary Atresia - mortality
Biliary Atresia - surgery
Biological and medical sciences
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Length of Stay
Liver Transplantation
Liver, biliary tract, pancreas, portal circulation, spleen
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Malformations
Medical sciences
Metabolic Diseases - mortality
Metabolic Diseases - surgery
Original Article
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Treatment Outcome
title Comparison of Outcome after Pediatric Liver Transplantation for Metabolic Diseases and Biliary Atresia
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