Predictors of Survival Following Liver Transplantation in Infants: A Single-Center Analysis of More Than 200 Cases
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| Veröffentlicht in: | Transplantation 2010-03, Vol.89 (5), p.600-605 |
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| creator | VENICK, Robert S FARMER, Douglas G MCDIARMID, Sue V DUFFY, John P GORDON, Sherilyn A YERSIZ, Hasan HONG, Johnny C VARGAS, Jorge H AMENT, Marvin E BUSUTTIL, Ronald W |
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| doi_str_mv | 10.1097/tp.0b013e3181c5cdc1 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_746014916</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>746014916</sourcerecordid><originalsourceid>FETCH-LOGICAL-c477t-8b92c445a4ed6cee9acc7dd5a1cab58ef5e9e10d047b1fd2c12e884c334a482f3</originalsourceid><addsrcrecordid>eNqF0VFrFDEQB_Agir1WP4EgeRGfts5sks3Gt-NobeHEQs_nJZud1UguOZO9K_32rvao0Jc-hYHf_GHyZ-wdwjmC0Z-m3Tn0gIIEtuiUGxy-YAtUQlYNtPCSLQAkViiEPmGnpfwCACW0fs1O0BijoYEFyzeZBu-mlAtPI7_d54M_2MAvUwjpzscffO0PlPkm21h2wcbJTj5F7iO_juM8ls98yW9nGKhaUZxmu4w23Bf_L_BrysQ3P23kNQBf2ULlDXs12lDo7fE9Y98vLzarq2r97cv1armunNR6qtre1E5KZSUNjSMy1jk9DMqis71qaVRkCGEAqXsch9phTW0rnRDSyrYexRn7-JC7y-n3nsrUbX1xFOYjKO1Lp2UDKA02z0shGiNAmlmKB-lyKiXT2O2y39p83yF0f1vpNjfd01bmrffH_H2_peH_zrGGGXw4AlucDeP82c6XR1fXSoJQjfgD4RuXdw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733693049</pqid></control><display><type>article</type><title>Predictors of Survival Following Liver Transplantation in Infants: A Single-Center Analysis of More Than 200 Cases</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>VENICK, Robert S ; FARMER, Douglas G ; MCDIARMID, Sue V ; DUFFY, John P ; GORDON, Sherilyn A ; YERSIZ, Hasan ; HONG, Johnny C ; VARGAS, Jorge H ; AMENT, Marvin E ; BUSUTTIL, Ronald W</creator><creatorcontrib>VENICK, Robert S ; FARMER, Douglas G ; MCDIARMID, Sue V ; DUFFY, John P ; GORDON, Sherilyn A ; YERSIZ, Hasan ; HONG, Johnny C ; VARGAS, Jorge H ; AMENT, Marvin E ; BUSUTTIL, Ronald W</creatorcontrib><description>Infants (<12 months) who require liver transplantation (LTx) represent a particularly challenging and understudied group of patients.
This retrospective study aimed to describe a large single-center experience of infants who received isolated LTx, illustrate important differences in infants versus older children, and identify pretransplant factors which influence survival. More than 25 pre-LTx demographic, laboratory, and operative variables were analyzed using the Log-rank test and Cox proportional hazards model.
Between 1984 and 2006, 216 LTx were performed in 186 infants with a mean follow-up time of 62 months. Median age at LTx was 9 months, the majority had cholestatic liver disease, were hospitalized pre-LTx, and received whole grafts. Leading indications for re-LTx (n=30) included vascular complications (43%) and graft nonfunction (40%), whereas leading causes of death were sepsis and multiorgan failure. One-, 5-, and 10-year graft and patient survivals were 75%/72%/68% and 79%/77%/75%, respectively. Relative to older pediatric recipients, infants had worse overall patient survival (P=0.05). The following were significant univariate predictors of graft loss: age less than 6 months and reduced cadaveric grafts; and of patient loss: age less than 6 months, calculated CrCl less than 90, pre-LTx hospitalization, pre-LTx mechanical ventilation, repeat LTx, infants transplanted for reasons other than cholestatic liver disease, and patients transplanted between 1984 and 1994.
Long-term outcomes for infants undergoing LTx are excellent and have improved over time. As the largest, single-center analysis of LTx in infants, this study elucidates a unique set of predictors that can aid in medical decision making.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/tp.0b013e3181c5cdc1</identifier><identifier>PMID: 19997060</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Body Size ; Cholestasis - surgery ; Cohort Studies ; Creatinine - blood ; Decision Making ; Ethnic Groups ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Glomerular Filtration Rate ; Graft Survival - physiology ; Humans ; Infant ; Liver Failure - surgery ; Liver Transplantation - mortality ; Liver Transplantation - physiology ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Predictive Value of Tests ; Renal Replacement Therapy - statistics & numerical data ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Rate ; Time Factors ; Tissue, organ and graft immunology</subject><ispartof>Transplantation, 2010-03, Vol.89 (5), p.600-605</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-8b92c445a4ed6cee9acc7dd5a1cab58ef5e9e10d047b1fd2c12e884c334a482f3</citedby><cites>FETCH-LOGICAL-c477t-8b92c445a4ed6cee9acc7dd5a1cab58ef5e9e10d047b1fd2c12e884c334a482f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22540356$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19997060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>VENICK, Robert S</creatorcontrib><creatorcontrib>FARMER, Douglas G</creatorcontrib><creatorcontrib>MCDIARMID, Sue V</creatorcontrib><creatorcontrib>DUFFY, John P</creatorcontrib><creatorcontrib>GORDON, Sherilyn A</creatorcontrib><creatorcontrib>YERSIZ, Hasan</creatorcontrib><creatorcontrib>HONG, Johnny C</creatorcontrib><creatorcontrib>VARGAS, Jorge H</creatorcontrib><creatorcontrib>AMENT, Marvin E</creatorcontrib><creatorcontrib>BUSUTTIL, Ronald W</creatorcontrib><title>Predictors of Survival Following Liver Transplantation in Infants: A Single-Center Analysis of More Than 200 Cases</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Infants (<12 months) who require liver transplantation (LTx) represent a particularly challenging and understudied group of patients.
This retrospective study aimed to describe a large single-center experience of infants who received isolated LTx, illustrate important differences in infants versus older children, and identify pretransplant factors which influence survival. More than 25 pre-LTx demographic, laboratory, and operative variables were analyzed using the Log-rank test and Cox proportional hazards model.
Between 1984 and 2006, 216 LTx were performed in 186 infants with a mean follow-up time of 62 months. Median age at LTx was 9 months, the majority had cholestatic liver disease, were hospitalized pre-LTx, and received whole grafts. Leading indications for re-LTx (n=30) included vascular complications (43%) and graft nonfunction (40%), whereas leading causes of death were sepsis and multiorgan failure. One-, 5-, and 10-year graft and patient survivals were 75%/72%/68% and 79%/77%/75%, respectively. Relative to older pediatric recipients, infants had worse overall patient survival (P=0.05). The following were significant univariate predictors of graft loss: age less than 6 months and reduced cadaveric grafts; and of patient loss: age less than 6 months, calculated CrCl less than 90, pre-LTx hospitalization, pre-LTx mechanical ventilation, repeat LTx, infants transplanted for reasons other than cholestatic liver disease, and patients transplanted between 1984 and 1994.
Long-term outcomes for infants undergoing LTx are excellent and have improved over time. As the largest, single-center analysis of LTx in infants, this study elucidates a unique set of predictors that can aid in medical decision making.</description><subject>Biological and medical sciences</subject><subject>Body Size</subject><subject>Cholestasis - surgery</subject><subject>Cohort Studies</subject><subject>Creatinine - blood</subject><subject>Decision Making</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Glomerular Filtration Rate</subject><subject>Graft Survival - physiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Liver Failure - surgery</subject><subject>Liver Transplantation - mortality</subject><subject>Liver Transplantation - physiology</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Predictive Value of Tests</subject><subject>Renal Replacement Therapy - statistics & numerical data</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>Survival Rate</subject><subject>Time Factors</subject><subject>Tissue, organ and graft immunology</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0VFrFDEQB_Agir1WP4EgeRGfts5sks3Gt-NobeHEQs_nJZud1UguOZO9K_32rvao0Jc-hYHf_GHyZ-wdwjmC0Z-m3Tn0gIIEtuiUGxy-YAtUQlYNtPCSLQAkViiEPmGnpfwCACW0fs1O0BijoYEFyzeZBu-mlAtPI7_d54M_2MAvUwjpzscffO0PlPkm21h2wcbJTj5F7iO_juM8ls98yW9nGKhaUZxmu4w23Bf_L_BrysQ3P23kNQBf2ULlDXs12lDo7fE9Y98vLzarq2r97cv1armunNR6qtre1E5KZSUNjSMy1jk9DMqis71qaVRkCGEAqXsch9phTW0rnRDSyrYexRn7-JC7y-n3nsrUbX1xFOYjKO1Lp2UDKA02z0shGiNAmlmKB-lyKiXT2O2y39p83yF0f1vpNjfd01bmrffH_H2_peH_zrGGGXw4AlucDeP82c6XR1fXSoJQjfgD4RuXdw</recordid><startdate>20100315</startdate><enddate>20100315</enddate><creator>VENICK, Robert S</creator><creator>FARMER, Douglas G</creator><creator>MCDIARMID, Sue V</creator><creator>DUFFY, John P</creator><creator>GORDON, Sherilyn A</creator><creator>YERSIZ, Hasan</creator><creator>HONG, Johnny C</creator><creator>VARGAS, Jorge H</creator><creator>AMENT, Marvin E</creator><creator>BUSUTTIL, Ronald W</creator><general>Lippincott Williams & Wilkins</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><scope>7QL</scope><scope>7T5</scope><scope>C1K</scope><scope>H94</scope></search><sort><creationdate>20100315</creationdate><title>Predictors of Survival Following Liver Transplantation in Infants: A Single-Center Analysis of More Than 200 Cases</title><author>VENICK, Robert S ; FARMER, Douglas G ; MCDIARMID, Sue V ; DUFFY, John P ; GORDON, Sherilyn A ; YERSIZ, Hasan ; HONG, Johnny C ; VARGAS, Jorge H ; AMENT, Marvin E ; BUSUTTIL, Ronald W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-8b92c445a4ed6cee9acc7dd5a1cab58ef5e9e10d047b1fd2c12e884c334a482f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Biological and medical sciences</topic><topic>Body Size</topic><topic>Cholestasis - surgery</topic><topic>Cohort Studies</topic><topic>Creatinine - blood</topic><topic>Decision Making</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Glomerular Filtration Rate</topic><topic>Graft Survival - physiology</topic><topic>Humans</topic><topic>Infant</topic><topic>Liver Failure - surgery</topic><topic>Liver Transplantation - mortality</topic><topic>Liver Transplantation - physiology</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Predictive Value of Tests</topic><topic>Renal Replacement Therapy - statistics & numerical data</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>Survival Rate</topic><topic>Time Factors</topic><topic>Tissue, organ and graft immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VENICK, Robert S</creatorcontrib><creatorcontrib>FARMER, Douglas G</creatorcontrib><creatorcontrib>MCDIARMID, Sue V</creatorcontrib><creatorcontrib>DUFFY, John P</creatorcontrib><creatorcontrib>GORDON, Sherilyn A</creatorcontrib><creatorcontrib>YERSIZ, Hasan</creatorcontrib><creatorcontrib>HONG, Johnny C</creatorcontrib><creatorcontrib>VARGAS, Jorge H</creatorcontrib><creatorcontrib>AMENT, Marvin E</creatorcontrib><creatorcontrib>BUSUTTIL, Ronald W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Immunology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>VENICK, Robert S</au><au>FARMER, Douglas G</au><au>MCDIARMID, Sue V</au><au>DUFFY, John P</au><au>GORDON, Sherilyn A</au><au>YERSIZ, Hasan</au><au>HONG, Johnny C</au><au>VARGAS, Jorge H</au><au>AMENT, Marvin E</au><au>BUSUTTIL, Ronald W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Survival Following Liver Transplantation in Infants: A Single-Center Analysis of More Than 200 Cases</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2010-03-15</date><risdate>2010</risdate><volume>89</volume><issue>5</issue><spage>600</spage><epage>605</epage><pages>600-605</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Infants (<12 months) who require liver transplantation (LTx) represent a particularly challenging and understudied group of patients.
This retrospective study aimed to describe a large single-center experience of infants who received isolated LTx, illustrate important differences in infants versus older children, and identify pretransplant factors which influence survival. More than 25 pre-LTx demographic, laboratory, and operative variables were analyzed using the Log-rank test and Cox proportional hazards model.
Between 1984 and 2006, 216 LTx were performed in 186 infants with a mean follow-up time of 62 months. Median age at LTx was 9 months, the majority had cholestatic liver disease, were hospitalized pre-LTx, and received whole grafts. Leading indications for re-LTx (n=30) included vascular complications (43%) and graft nonfunction (40%), whereas leading causes of death were sepsis and multiorgan failure. One-, 5-, and 10-year graft and patient survivals were 75%/72%/68% and 79%/77%/75%, respectively. Relative to older pediatric recipients, infants had worse overall patient survival (P=0.05). The following were significant univariate predictors of graft loss: age less than 6 months and reduced cadaveric grafts; and of patient loss: age less than 6 months, calculated CrCl less than 90, pre-LTx hospitalization, pre-LTx mechanical ventilation, repeat LTx, infants transplanted for reasons other than cholestatic liver disease, and patients transplanted between 1984 and 1994.
Long-term outcomes for infants undergoing LTx are excellent and have improved over time. As the largest, single-center analysis of LTx in infants, this study elucidates a unique set of predictors that can aid in medical decision making.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>19997060</pmid><doi>10.1097/tp.0b013e3181c5cdc1</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0041-1337 |
| ispartof | Transplantation, 2010-03, Vol.89 (5), p.600-605 |
| issn | 0041-1337 1534-6080 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Biological and medical sciences Body Size Cholestasis - surgery Cohort Studies Creatinine - blood Decision Making Ethnic Groups Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Fundamental immunology Glomerular Filtration Rate Graft Survival - physiology Humans Infant Liver Failure - surgery Liver Transplantation - mortality Liver Transplantation - physiology Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Predictive Value of Tests Renal Replacement Therapy - statistics & numerical data Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Rate Time Factors Tissue, organ and graft immunology |
| title | Predictors of Survival Following Liver Transplantation in Infants: A Single-Center Analysis of More Than 200 Cases |
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