Orthotopic Liver Transplantation in Children: Two-year Experience with 47 Patients

Overview

Journal Pediatrics

Specialty Pediatrics

Date 1984 Jul 1

PMID 6377219

Citations 28

Authors

J C Gartner Jr

B J Zitelli

J J Malatack

B W Shaw

S Iwatsuki

T E Starzl

Affiliations

Soon will be listed here.

Abstract

During a 24-month period (May 1981 to May 1983), 47 pediatric patients (ranging in age from 7 months to 18 years) underwent orthotopic liver transplantation using cyclosporine and prednisone. Major indications were biliary atresia/hypoplasia, and metabolic liver disease. Thirty-two of 138 patients evaluated for the procedure died prior to transplantation. Thirty patients are alive from 6 to 29 months later including 7/15 patients who required retransplantation. Twenty-one of 32 patients are alive at 1 year following initial transplantation. All 30 survivors are clinically well and living at home; only one has an abnormal bilirubin level. Serious, life-threatening medical and surgical complications were common during the early months following transplantation. With one exception, deaths and major rejection episodes occurred early (before 120 days). All survivors are relieved of the stigmata of chronic liver disease, and many have demonstrated catch-up growth. Liver transplantation is an effective treatment for end-stage pediatric liver disease.

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References

Starzl T, Koep L, Halgrimson C, Hood J, Schroter G, Porter K . Fifteen years of clinical liver transplantation. Gastroenterology. 1979; 77(2):375-88. PMC: 3091390. View

Bird A, Britton S . The relationship between Epstein-Barr virus and lymphoma. Semin Hematol. 1982; 19(4):285-300. View

Altman R . Biliary atresia. Pediatrics. 1981; 68(6):896-8. View

Zitelli B, Malatack J, Gartner Jr J, Shaw B, Iwatsuki S, Starzl T . Orthotopic Liver Transplantation in Children With Hepatic-Based Metabolic Disease. Transplant Proc. 2010; 15(1):1284-1287. PMC: 3000126. View

Bernstein D . After transplantation--the child's emotional reactions. Am J Psychiatry. 1971; 127(9):1189-93. DOI: 10.1176/ajp.127.9.1189. View

Malatack J, Finegold D, Iwatsuki S, Shaw Jr B, Gartner J, Zitelli B . Liver transplantation for type I glycogen storage disease. Lancet. 1983; 1(8333):1073-5. PMC: 3022514. DOI: 10.1016/s0140-6736(83)91910-4. View

Hood J, Koep L, Peters R, Schroter G, Weil 3rd R, Redeker A . Liver transplantation for advanced liver disease with alpha-1-antitrypsin deficiency. N Engl J Med. 1980; 302(5):272-5. PMC: 2777525. DOI: 10.1056/NEJM198001313020505. View

Khan A, HERNDON C, Ahmadian S . Social and emotional adaptations of children with transplanted kidneys and chronic hemodialysis. Am J Psychiatry. 1971; 127(9):1194-8. DOI: 10.1176/ajp.127.9.1194. View

Starzl T, Klintmalm G, Porter K, Iwatsuki S, Schroter G . Liver transplantation with use of cyclosporin a and prednisone. N Engl J Med. 1981; 305(5):266-9. PMC: 2772056. DOI: 10.1056/NEJM198107303050507. View

10.

Starzl T, Koep L, Schroter G, Halgrimson C, Porter K, Weil 3rd R . Liver replacement for pediatric patients. Pediatrics. 1979; 63(6):825-9. PMC: 2975972. View

11.

Starzl T, Iwatsuki S, Malatack J, Zitelli B, Gartner Jr J, Hakala T . Liver and kidney transplantation in children receiving cyclosporin A and steroids. J Pediatr. 1982; 100(5):681-6. PMC: 3035841. DOI: 10.1016/s0022-3476(82)80564-7. View

12.

Borel J, Feurer C, GUBLER H, STAHELIN H . Biological effects of cyclosporin A: a new antilymphocytic agent. Agents Actions. 1976; 6(4):468-75. DOI: 10.1007/BF01973261. View

13.

Sawchuk R, Cartier L . Liquid-chromatographic determination of cyclosporin A in blood and plasma. Clin Chem. 1981; 27(8):1368-71. View

14.

Borel J, Feurer C, Magnee C, STAHELIN H . Effects of the new anti-lymphocytic peptide cyclosporin A in animals. Immunology. 1977; 32(6):1017-25. PMC: 1445439. View

15.

Neville B, Lake B, Stephens R, Sanders M . A neurovisceral storage disease with vertical supranuclear ophthalmoplegia, and its relationship to Niemann-Pick disease. A report of nine patients. Brain. 1973; 96(1):97-120. DOI: 10.1093/brain/96.1.97. View

16.

Starzl T, Iwatsuki S, Klintmalm G, Schroter G, Weil 3rd R, Koep L . Liver transplantation, 1980, with particular reference to cyclosporin-A. Transplant Proc. 1981; 13(1 Pt 1):281-5. PMC: 2845441. View

17.

Lilly J, Starzl T . Liver transplantation in children with biliary atresia and vascular anomalies. J Pediatr Surg. 1974; 9(5):707-14. PMC: 2976667. DOI: 10.1016/0022-3468(74)90109-2. View

18.

Starzl T, Koep L, Porter K, Schroter G, Weil 3rd R, Hartley R . Decline in survival after liver transplantation. Arch Surg. 1980; 115(7):815-9. PMC: 2962607. DOI: 10.1001/archsurg.1980.01380070009002. View

19.

Penn I, Bunch D, Olenik D, Abouna G . Psychiatric experience with patients receiving renal nad hepatic transplants. Semin Psychiatry. 1971; 3(1):133-44. View

20.

Iwatsuki S, Klintmalm G, Starzl T . Total hepatectomy and liver replacement (orthotopic liver transplantation) for primary hepatic malignancy. World J Surg. 1982; 6(1):81-5. PMC: 3002428. DOI: 10.1007/BF01656377. View