A Retrospective Study of Long-Term Outcomes in 16 ABO-Incompatible Deceased Donor Pediatric Liver Transplants from a National Transplant Center at Helsinki University Hospital, Finland, 1987-2022.

IF 1.1 4区 医学 Q3 SURGERY Annals of Transplantation Pub Date : 2024-02-13 DOI:10.12659/AOT.941929
Timo Jahnukainen, Inna Sareneva, Jouni Lauronen, Elisa Ylinen, Juuso Tainio, Arno Nordin, Maria Hukkinen, Mikko P Pakarinen, Hannu Jalanko
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Abstract

BACKGROUND The use of ABO-incompatible liver transplants (ABO-ILTs) from deceased donors has become more common due to the shortage of available donor livers and increased transplant waiting times. This retrospective study from a national transplant center at Helsinki University Hospital, Finland, aimed to assess the long-term outcomes of ABO-incompatible deceased donor pediatric liver transplants between 1987 and 2022. MATERIAL AND METHODS Sixteen (9.5%) of the 169 pediatric liver transplantations were ABO-ILTs. The median age at transplantation was 5.0 (0.5-15.4) years. Reasons for ABO-ILTs were acute liver failure (18.75%), malignancy (12.5%), small body size and long waiting time (25%), and other reasons (43.75%). The median post-transplant follow-up time was 147 (0.72-353) months. Patient and graft survival and occurrence of surgical complications were compared to ABO-identical transplants, and anti-ABO antibody titers were analyzed. RESULTS The 1-, 3-, and 5-year patient survivals were comparable between the ABO-I and ABO-compatible groups, being 81.3%, 73.9%, and 73.9% (ABO-I) and 87.5%, 82.5%, 77.9% (ABO-compatible), respectively. Three patients with ABO-ILTs died of sepsis and multiorgan failure during the first 3 months after transplantation. The occurrence of biliary complications and early vascular thrombosis (<30 days after transplantation) did not differ significantly between recipients with an ABO-ILT vs ABO-compatible liver graft. CONCLUSIONS The findings from this study support findings from previous studies that outcomes after ABO-incompatible liver transplants in children were comparable to outcomes from ABO-identical liver transplants.

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1987-2022年芬兰赫尔辛基大学医院国家移植中心对16例ABO血型不相容死亡供体小儿肝脏移植手术长期结果的回顾性研究。
背景由于可用供体肝脏的短缺和移植等待时间的延长,使用已故供体进行ABO不相容肝脏移植(ABO-ILT)已变得越来越普遍。这项来自芬兰赫尔辛基大学医院国家移植中心的回顾性研究旨在评估1987年至2022年期间ABO不相容死亡供体小儿肝移植的长期结果。材料和方法 在169例小儿肝移植中,有16例(9.5%)为ABO-ILT。移植时的中位年龄为 5.0(0.5-15.4)岁。ABO-ILT的原因包括急性肝功能衰竭(18.75%)、恶性肿瘤(12.5%)、体型小和等待时间长(25%)以及其他原因(43.75%)。移植后随访时间的中位数为 147(0.72-353)个月。将患者和移植物的存活率以及手术并发症的发生率与ABO血型相同的移植进行了比较,并对抗ABO抗体滴度进行了分析。结果 ABO-I 组和 ABO 相容组患者的 1 年、3 年和 5 年存活率相当,分别为 81.3%、73.9% 和 73.9%(ABO-I 组)以及 87.5%、82.5% 和 77.9%(ABO 相容组)。3名ABO-ILT患者在移植后的头3个月死于败血症和多器官功能衰竭。胆道并发症和早期血管血栓形成((
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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
79
审稿时长
>12 weeks
期刊介绍: Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation. Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time to first decision is around 3-4 weeks. Time to publication of accepted manuscripts continues to be shortened, with the Editorial team committed to a goal of 3 months from acceptance to publication. Expert reseachers and clinicians from around the world contribute original Articles, Review Papers, Case Reports and Special Reports in every pertinent specialty, providing a lot of arguments for discussion of exciting developments and controversies in the field.
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