CHICAGO Children who undergo liver transplantation have better survival rates with living donor liver transplant graft than with deceased donor organ transplant, although factors other than the type of graft also are important, according to a study in the May issue of Archives of Surgery, one of the JAMA/Archives journals.

While the number of children waiting for a liver transplant has doubled since 1993, children under five are the most likely to die while waiting for a liver transplant, according to background information in the article. The need for small-sized grafts coupled with a critical organ shortage have necessitated a turn to alternative sources for children with end-stage liver disease, including living donor liver transplantation (LDLT). In living donor liver transplantation a portion of an adult's healthy liver is transplanted into a child. This is feasible because of the child's smaller size and the ability of the adult liver to regenerate. Although living donor liver transplantation provides a valuable resource for transplantation, the authors note that it also poses some risk to an otherwise healthy donor. Therefore, it is crucial that the transplantation community carefully select candidates for living donor liver transplantation and evaluate the outcomes.

Mary T. Austin, M.D., of Vanderbilt University Medical Center, Nashville, Tenn., and colleagues analyzed data on all pediatric recipients of liver transplants from the United Network for Organ Sharing (UNOS) database from October 1, 1987 to May 24, 2004 to identify variables that would predict graft and patient outcome and to compare the outcomes achieved among the different donor types: deceased donor whole organ transplantations, deceased donor split organ transplantation and living donor liver transplantation.

During that period, 8,771 liver transplantations were performed in the U. S. on children with end-stage liver disease. Of those, 81 percent were deceased dono
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Contact: Clinton Colmenares
615-322-4747
JAMA and Archives Journals
16-May-2005

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