Effect of small donor weight and donor-recipient weight ratio on the outcome of liver transplantation in children.

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Citation: Pediatric Transplantation. 19(4):366-70, 2015 Jun.PMID: 25819141Institution: MedStar Washington Hospital CenterDepartment: Surgery/TransplantationForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Liver Transplantation | *Organ Size | *Thrombosis/pp [Physiopathology] | Adolescent | Body Weight | Cadaver | Child | Child, Preschool | Female | Graft Survival | Hepatic Artery/pp [Physiopathology] | Humans | Liver Failure/su [Surgery] | Living Donors | Male | Proportional Hazards Models | Registries | Regression Analysis | Risk Factors | ROC Curve | Tissue and Organ ProcurementYear: 2015ISSN:
  • 1397-3142
Name of journal: Pediatric transplantationAbstract: A small donor weight is a risk factor for HAT with potential for graft loss. To test this hypothesis, we evaluated outcomes of pediatric liver transplants utilizing donors <20 kg using the UNOS database from 01/2003 to 01/2012 (n = 1311). All isolated liver transplants with whole organ grafts were included. Recipients were divided into four groups based on donor weight: group 1, donor weight <5 kg (n = 34 [2%]); group 2, 5-10 kg (431 [33%]); group 3, 10-15 kg (560 [43%]); and group 4, 15-20 kg (286 [22%]). Actuarial patient survival for the first year post-transplant was significantly lower in groups 1 and 2 compared to groups 3 and 4 (p = 0.002), similarly the one-yr graft function (p < 0.0001). The difference was due to graft loss within the first month for groups 1 and 2. HAT was significantly higher in groups 1 and 2 compared to others (p = 0.0006). Logistic regression analysis demonstrated donor weight as the most predictive factor with analysis of the ROC curve showing a cutoff point at 7.8 kg. The donor-recipient weight ratio did, in none of the models, gain statistical significance.Copyright © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.All authors: Desai CS, Fishbein T, Gruessner A, Kaufman S, Khan KM, Sharma SFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-05-24
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Journal Article MedStar Authors Catalog Article 25819141 Available 25819141

A small donor weight is a risk factor for HAT with potential for graft loss. To test this hypothesis, we evaluated outcomes of pediatric liver transplants utilizing donors <20 kg using the UNOS database from 01/2003 to 01/2012 (n = 1311). All isolated liver transplants with whole organ grafts were included. Recipients were divided into four groups based on donor weight: group 1, donor weight <5 kg (n = 34 [2%]); group 2, 5-10 kg (431 [33%]); group 3, 10-15 kg (560 [43%]); and group 4, 15-20 kg (286 [22%]). Actuarial patient survival for the first year post-transplant was significantly lower in groups 1 and 2 compared to groups 3 and 4 (p = 0.002), similarly the one-yr graft function (p < 0.0001). The difference was due to graft loss within the first month for groups 1 and 2. HAT was significantly higher in groups 1 and 2 compared to others (p = 0.0006). Logistic regression analysis demonstrated donor weight as the most predictive factor with analysis of the ROC curve showing a cutoff point at 7.8 kg. The donor-recipient weight ratio did, in none of the models, gain statistical significance.Copyright © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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