AI Article Synopsis
- The study aimed to evaluate long-term graft and patient survival rates in children who underwent liver retransplantation in Australia and New Zealand from 1986 to 2017, as well as factors affecting these outcomes.!
- A total of 142 liver retransplantations were performed, with a notable improvement in survival rates during the later period of 2001-2017 compared to 1986-2000, indicating advancements in medical practices.!
- Overall graft and patient survival rates were high, especially in the more recent years, and it was found that children needing retransplantation should have equal access to donor grafts as those needing their first transplant.!
Article Abstract
Objective: To assess long term graft and patient survival after donor liver retransplantation in children in Australia and New Zealand during 1986-2017; to determine the factors that influence survival.
Design: Retrospective cohort analysis (registry data).
Setting, Participants: Australia and New Zealand Liver Transplant Registry data for all liver retransplantations in children (under 18 years of age), 1986-2017, in all four paediatric and six adult liver transplantation centres in the two countries.
Main Outcome Measures: Graft and patient survival at one, 5, 10 and 15 years.
Results: 142 liver retransplantations were undertaken in children (59 during 1986-2000, 83 during 2001-2017). Kaplan-Meier survival analysis indicated that survival was significantly greater during 2001-2017 than 1986-2000 (P < 0.001). During 2001-2017, graft survival one year after retransplantation was 84%, at 5 years 75%, at 10 years 70%, and at 15 years 54%; patient survival was 89% at one year, 87% at 5 years, 87% at 10 years, and 71% at 15 years. Median time between transplantations was 0.2 years (IQR, 0.03-1.4 years) during 1986-2000, and 1.8 years (IQR, 0.1-6.8 years) during 2001-2017 (P = 0.002). The proportion of graft failures that involved split grafts was larger during 2001-2017 (35 of 83, 42%) than 1986-2000 (10 of 59, 17%). Graft type, cause of graft failure, and number of transplants did not influence survival following retransplantation.
Conclusion: Survival for children following retransplantation is excellent. Graft survival is similar for split and whole grafts. Children on the liver waiting list requiring retransplantation should have the same access to donor grafts as children requiring a first transplant.
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| http://dx.doi.org/10.5694/mja2.50802 | DOI Listing |
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