Scott A Elisofon1, John C Magee2, Vicky L Ng3, Simon P Horslen4, Vicki Fioravanti5, Julie Economides6, Jinson Erinjeri7, Ravinder Anand7, George V Mazariegos8. 1. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts. 2. Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan. 3. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. 4. Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington. 5. Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri. 6. Transplant Services, Texas Children's Hospital, Houston, Texas. 7. Emmes Company, LLC, Rockville, Maryland. 8. Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Abstract
BACKGROUND: SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE: To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS: This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS: A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
BACKGROUND: SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE: To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS: This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS: A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
Authors: Jean de Ville de Goyet; Toni Illhardt; Christophe Chardot; Peace N Dike; Ulrich Baumann; Katherine Brandt; Barbara E Wildhaber; Mikko Pakarinen; Fabrizio di Francesco; Ekkehard Sturm; Marianna Cornet; Caroline Lemoine; Eva Doreen Pfister; Ana M Calinescu; Maria Hukkinen; Sanjiv Harpavat; Fabio Tuzzolino; Riccardo Superina Journal: J Clin Med Date: 2022-04-12 Impact factor: 4.964
Authors: Mounika Kanneganti; Yuwen Xu; Yuan-Shung Huang; Eimear Kitt; Brian T Fisher; Peter L Abt; Elizabeth B Rand; Douglas E Schaubel; Therese Bittermann Journal: Liver Transpl Date: 2021-08-25 Impact factor: 5.799