Recipient body size dose not matter in paediatric liver transplantation

Abstract

BACKGROUND/PURPOSE: It is controversial whether small-sized recipient is associated with adverse outcome in liver transplantation. This study aims to evaluate the outcomes of paediatric liver transplantation according to the body weight of recipients METHODS: Liver transplant recipients (age < 18, from 1993 to 2011) were studied retrospectively. They were categorized according to the body size at the time of transplantation (A: <6kg, B: between 6kg to 10kg, C: >10kg) RESULTS: A total of 113 patients (83 LDLTs and 30 DDLTs) were studied. Thirteen (11.5%) belonged to group A; 56 (49.6%) belonged to group B and 44 (38.9%) belonged to group C. The best graft and patient survivals were found in group A and none of the patients required re-laparotomy for general surgical complications while 32 (32%) in group B and C did. Regarding transplant-related complications, although group A patients had the highest incidence of biliary stricture (30.7%, n=4), the incidence of vascular complications (hepatic artery : 7%; portal vein: 0% and hepatic vein: 0%) was the lowest among the three groups. CONCLUSIONS: Outcomes of small-sized recipients are not inferior. Less technical-related vascular complications, which may lead to early graft loss, were observed. This could be patient-related (less advanced cirrhosis) or surgeon-related (additional attention paid).