dc.contributor.author
Moosburner, Simon
dc.contributor.author
Wiering, Leke
dc.contributor.author
Gül-Klein, Safak
dc.contributor.author
Ritschl, Paul
dc.contributor.author
Dziodzio, Tomasz
dc.contributor.author
Raschzok, Nathanael
dc.contributor.author
Witzel, Christian
dc.contributor.author
Gratopp, Alexander
dc.contributor.author
Henning, Stephan
dc.contributor.author
Bufler, Philip
dc.contributor.author
Schmelzle, Moritz
dc.contributor.author
Lurje, Georg
dc.contributor.author
Schöning, Wenzel
dc.contributor.author
Pratschke, Johann
dc.contributor.author
Globke, Brigitta
dc.contributor.author
Öllinger, Robert
dc.date.accessioned
2022-08-24T12:00:29Z
dc.date.available
2022-08-24T12:00:29Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/36006
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-35721
dc.description.abstract
Background: Pediatric liver transplantation (LT) is the treatment of choice for children with end-stage liver disease and in certain cases of hepatic malignancies. Due to low case numbers, a technically demanding procedure, the need for highly specialized perioperative intensive care, and immunological, as well as infectious, challenges, the highest level of interdisciplinary cooperation is required. The aim of our study was to analyze short- and long-term outcomes of pediatric LT in our center.
Methods: We conducted a retrospective single-center analysis of all liver transplantations in pediatric patients (≤16 years) performed at the Department of Surgery, Charité – Universitätsmedizin Berlin between 1991 and 2021. Three historic cohorts (1991–2004, 2005–2014 and 2015–2021) were defined. Graft- and patient survival, as well as perioperative parameters were analyzed. The study was approved by the institutional ethics board.
Results: Over the course of the 30-year study period, 212 pediatric LTs were performed at our center. The median patient age was 2 years (IQR 11 years). Gender was equally distributed (52% female patients). The main indications for liver transplantation were biliary atresia (34%), acute hepatic necrosis (27%) and metabolic diseases (13%). The rate of living donor LT was 25%. The median cold ischemia time for donation after brain death (DBD) LT was 9 h and 33 min (IQR 3 h and 46 min). The overall donor age was 15 years for DBD donors and 32 years for living donors. Overall, respective 1, 5, 10 and 30-year patient and graft survivals were 86%, 82%, 78% and 65%, and 78%, 74%, 69% and 55%. One-year patient survival was 85%, 84% and 93% in the first, second and third cohort, respectively (p = 0.14). The overall re-transplantation rate was 12% (n = 26), with 5 patients (2%) requiring re-transplantation within the first 30 days.
Conclusion: The excellent long-term survival over 30 years showcases the effectiveness of liver transplantation in pediatric patients. Despite a decrease in DBD organ donation, patient survival improved, attributed, besides refinements in surgical technique, mainly to improved interdisciplinary collaboration and management of perioperative complications.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
pediatric liver transplantation
en
dc.subject
early allograft dysfunction
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Over 30 Years of Pediatric Liver Transplantation at the Charité—Universitätsmedizin Berlin
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
900
dcterms.bibliographicCitation.doi
10.3390/jcm11040900
dcterms.bibliographicCitation.journaltitle
Journal of Clinical Medicine
dcterms.bibliographicCitation.number
4
dcterms.bibliographicCitation.originalpublishername
MDPI AG
dcterms.bibliographicCitation.volume
11
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
35207173
dcterms.isPartOf.eissn
2077-0383