Paediatric Living Donor Liver Transplantation: A single Centre Experience From Pakistan

Objective: To determine the outcomes of paediatric living donor liver transplantation (LDLT) recipients from Pakistan in terms of 90-day morbidity and mortality. Study Design: Cohort study. Place and Duration of Study: Shifa International Hospital, Islamabad, Pakistan, between April 2012 and April 2015. Methodology: All patients in paediatric age group (= 17 years) who underwent LDLT with a minimum follow-up of 3 months, were included. All grade 2 and above complications on Clavien-Dindo system were included as morbidity. The main outcome measure was 90-day morbidity and mortality. Result: Fourteen paediatric LDLTs were performed. Median age of the recipients was 8.5 years ranging between 6 months and 17 years. Wilson's disease and cryptogenic cirrhosis were the most common etiologies (28.6 percentage each). Acute liver failure was present in 5 (35.7 percentage) patients. Overall 90-day morbidity and mortality was 71.4 percentage and 14.2 percentage; both were attributable to pulmonary infection. No difference was observed in morbidity (21.3 percentage vs. 42.8 percentage, p=0.3) and mortality rates (20 percentage vs. 11 percentage, p=1.0) between patients with acute and chronic liver failure. Estimated 3-year survival was 85 percentage. Conclusion: Paediatric LDLT offers a promising treatment option for acute and chronic liver failure. Mortality was attributable to post-transplant pulmonary infections. (author)