J Pediatr 1987 Oct;111(4):479-89

Choosing a pediatric recipient for orthotopic liver transplantation.

Malatack JJ, Schaid DJ, Urbach AH, Gartner JC Jr, Zitelli BJ, Rockette H,
Fischer J, Starzl TE, Iwatsuki S, Shaw BW

Department of Pediatrics, University of Pittsburgh Health Center, PA.

Abstract

Between March 3, 1981, and June 1, 1984, 216 children were evaluated for
orthotopic liver transplantation. Of the 216 patients, 117 (55%) had received at
least one liver transplant by June 1, 1985. Fifty-five (25%) died before
transplantation. The 117 patients who received transplants were grouped
according to severity of disease and degree of general decompensation at the
time of transplantation. The severity of a patient's medical condition with the
possible exception of deep hepatic coma, did not predict outcome following
orthotopic liver transplantation. Seventy variables were assessed at the time of
the evaluation. Twenty-three of the 70 variables were found to have prognostic
significance with regard to death from progressive liver disease before
transplantation. These 23 variables were incorporated into a multivariate model
to provide a means of determining the relative risk of death among pediatric
patients with end-stage liver disease. This information may allow more informed
selection of candidates awaiting liver transplantation.