ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network
An increasing number of AB0-incompatible (AB0i) liver transplantations (LT) are being undertaken internationally in recent years due to organ shortages and the need for urgent transplantation. The aim of our study was establish the value of ABOi LT from available retrospective results of AB0i pediat...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-08-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/8/9/760 |
| _version_ | 1797519857334353920 |
|---|---|
| author | Małgorzata Markiewicz-Kijewska Piotr Kaliciński Juan Torres Canizales Angelo Di Giorgio Ulrich Baumann Carl Jorns Alastair Baker Maria Francelina Lopes Esteban Frauca Remacha Eduardo Lopez-Granados Paloma Jara Vega Maria-Sole Basso Grzegorz Kowalewski Diana Kamińska Sandra Ferreira Daniela Liccardo Andrea Pietrobattista Marco Spada on behalf of ERN TransplantChild Healthcare Working Group |
| author_facet | Małgorzata Markiewicz-Kijewska Piotr Kaliciński Juan Torres Canizales Angelo Di Giorgio Ulrich Baumann Carl Jorns Alastair Baker Maria Francelina Lopes Esteban Frauca Remacha Eduardo Lopez-Granados Paloma Jara Vega Maria-Sole Basso Grzegorz Kowalewski Diana Kamińska Sandra Ferreira Daniela Liccardo Andrea Pietrobattista Marco Spada on behalf of ERN TransplantChild Healthcare Working Group |
| author_sort | Małgorzata Markiewicz-Kijewska |
| collection | DOAJ |
| description | An increasing number of AB0-incompatible (AB0i) liver transplantations (LT) are being undertaken internationally in recent years due to organ shortages and the need for urgent transplantation. The aim of our study was establish the value of ABOi LT from available retrospective results of AB0i pediatric liver transplantations performed in European reference centers now belonging to the TransplantChild, European Reference Network (ERN). Data from medical records were analyzed, including demographic data, diagnosis, urgency of transplantation, time on the waiting list, PELD/MELD score, desensitization procedures, immunosuppression, selected post-transplant complications, and patient and graft survival. A total of 142 patients (pts) with transplants between 1986 and 2018 in 8 European transplant centers were included in the study. The indications for liver transplantation were: cholestatic diseases in 62 pts, acute liver failure in 42 pts, and other conditions in the remaining 38 pts. Sixty-six patients received grafts from living donors, and seventy-six received grafts from deceased donors. Both patient and graft survival were significantly affected by deceased donor type, urgent transplantation, and the development of vascular complications. In the multivariate analysis, vascular complications had a negative impact on patient and graft survival, while a longer time from the first AB0i LT in the study showed better results, suggesting an international learning experience. In conclusion, we believe that AB0i LT in children is now a safe procedure that may be adopted more readily in children. |
| first_indexed | 2024-03-10T07:48:43Z |
| format | Article |
| id | doaj.art-bf64197213704fafb55f8732e0520134 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T07:48:43Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-bf64197213704fafb55f8732e05201342023-11-22T12:29:38ZengMDPI AGChildren2227-90672021-08-018976010.3390/children8090760ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference NetworkMałgorzata Markiewicz-Kijewska0Piotr Kaliciński1Juan Torres Canizales2Angelo Di Giorgio3Ulrich Baumann4Carl Jorns5Alastair Baker6Maria Francelina Lopes7Esteban Frauca Remacha8Eduardo Lopez-Granados9Paloma Jara Vega10Maria-Sole Basso11Grzegorz Kowalewski12Diana Kamińska13Sandra Ferreira14Daniela Liccardo15Andrea Pietrobattista16Marco Spada17on behalf of ERN TransplantChild Healthcare Working GroupDepartment of Pediatric Surgery and Organ Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, PolandDepartment of Pediatric Surgery and Organ Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, PolandCenter for Biomedical Network Research on Rare Diseases (CIBERER U767), Lymphocyte Pathophysiology in Immunodeficiencies Group, Immunology Unit, La Paz Institute of Biomedical Research (IdiPAZ), La Paz University Hospital, 28046 Madrid, SpainDepartment of Pediatric Hepatology, Gastroenterology and Transplantation, ASST Hospital Papa Giovanni XXIII, 24127 Bergamo, ItalyDivision of Pediatric Gastroenterology and Hepatology, Hannover Medical School, 30625 Hannover, GermanyDepartment of Transplantation Surgery, Karolinska University Hospital, 171 76 Stockholm, SwedenPediatric Liver, Gastrointestinal and Nutrition Centre, King’s College London School of Medicine, King’s College Hospital, Denmark Hill, London SE5 9RS, UKDepartment of Pediatric Surgery, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, PortugalServicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, SpainCenter for Biomedical Network Research on Rare Diseases (CIBERER U767), Lymphocyte Pathophysiology in Immunodeficiencies Group, Immunology Unit, La Paz Institute of Biomedical Research (IdiPAZ), La Paz University Hospital, 28046 Madrid, SpainServicio de Hepatología Pediátrica, Hospital Universitario La Paz, 28046 Madrid, SpainDepartment of Hepatology, Gastroenterology and Nutrition, Ospedale Pediatrico Bambino Gesu, 00165 Roma, ItalyDepartment of Pediatric Surgery and Organ Transplantation, Children’s Memorial Health Institute, 04-730 Warsaw, PolandThe Department of Gastroenterology, Hepatology, Nutrition Disorder and Pediatric, The Children’s Memorial Health Institute, 04-730 Warsaw, PolandHepatology and Pediatric Liver Transplantation Unit, Centro Hospitalar e Universitário de Coimbra, 3000-075 Coimbra, PortugalDepartment of Hepatology, Gastroenterology and Nutrition, Ospedale Pediatrico Bambino Gesu, 00165 Roma, ItalyDepartment of Hepatology, Gastroenterology and Nutrition, Ospedale Pediatrico Bambino Gesu, 00165 Roma, ItalyDepartment of Abdominal Transplantation and Hepatobiliopancreatic Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, ItalyAn increasing number of AB0-incompatible (AB0i) liver transplantations (LT) are being undertaken internationally in recent years due to organ shortages and the need for urgent transplantation. The aim of our study was establish the value of ABOi LT from available retrospective results of AB0i pediatric liver transplantations performed in European reference centers now belonging to the TransplantChild, European Reference Network (ERN). Data from medical records were analyzed, including demographic data, diagnosis, urgency of transplantation, time on the waiting list, PELD/MELD score, desensitization procedures, immunosuppression, selected post-transplant complications, and patient and graft survival. A total of 142 patients (pts) with transplants between 1986 and 2018 in 8 European transplant centers were included in the study. The indications for liver transplantation were: cholestatic diseases in 62 pts, acute liver failure in 42 pts, and other conditions in the remaining 38 pts. Sixty-six patients received grafts from living donors, and seventy-six received grafts from deceased donors. Both patient and graft survival were significantly affected by deceased donor type, urgent transplantation, and the development of vascular complications. In the multivariate analysis, vascular complications had a negative impact on patient and graft survival, while a longer time from the first AB0i LT in the study showed better results, suggesting an international learning experience. In conclusion, we believe that AB0i LT in children is now a safe procedure that may be adopted more readily in children.https://www.mdpi.com/2227-9067/8/9/760AB0-incompatible liver transplantationchildrenimmunosuppressionrejectioncomplicationspatient survival |
| spellingShingle | Małgorzata Markiewicz-Kijewska Piotr Kaliciński Juan Torres Canizales Angelo Di Giorgio Ulrich Baumann Carl Jorns Alastair Baker Maria Francelina Lopes Esteban Frauca Remacha Eduardo Lopez-Granados Paloma Jara Vega Maria-Sole Basso Grzegorz Kowalewski Diana Kamińska Sandra Ferreira Daniela Liccardo Andrea Pietrobattista Marco Spada on behalf of ERN TransplantChild Healthcare Working Group ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network Children AB0-incompatible liver transplantation children immunosuppression rejection complications patient survival |
| title | ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network |
| title_full | ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network |
| title_fullStr | ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network |
| title_full_unstemmed | ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network |
| title_short | ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network |
| title_sort | abo incompatible liver transplantation in children a 20 year experience from centres in the transplantchild european reference network |
| topic | AB0-incompatible liver transplantation children immunosuppression rejection complications patient survival |
| url | https://www.mdpi.com/2227-9067/8/9/760 |
| work_keys_str_mv | AT małgorzatamarkiewiczkijewska aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT piotrkalicinski aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT juantorrescanizales aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT angelodigiorgio aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT ulrichbaumann aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT carljorns aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT alastairbaker aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT mariafrancelinalopes aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT estebanfraucaremacha aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT eduardolopezgranados aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT palomajaravega aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT mariasolebasso aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT grzegorzkowalewski aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT dianakaminska aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT sandraferreira aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT danielaliccardo aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT andreapietrobattista aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT marcospada aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork AT onbehalfoferntransplantchildhealthcareworkinggroup aboincompatiblelivertransplantationinchildrena20yearexperiencefromcentresinthetransplantchildeuropeanreferencenetwork |