J Pediatr 1987 Apr;110(4):545-8

Liver transplantation before 1 year of age

Esquivel CO, Koneru B, Karrer F, Todo S, Iwatsuki S, Gordon RD, Makowka L, Marsh
WJ Jr, Starzl TE

Abstract
Since 1981, 20 infants younger than 1 year of age received 26 orthotopic liver
transplants. Immunosuppression was with cyclosporine and corticosteroids.
Thirteen (65%) of the recipients were discharged from the hospital. To date, 12
(60%) of the 20 recipients are surviving, with follow-up of 1 to 56 months
(average 14 months). The 5-year actuarial survival is 53.8%. The allograft liver
function in the majority of surviving infants is excellent. The predominant
causes of mortality were primary nonfunction of the allograft (three patients)
and sepsis (three). Major morbidity was caused by hepatic artery thrombosis
(five patients), gastrointestinal complications (six), biliary tract
complications (five), and bacterial and viral infections (13). Six patients
underwent retransplantation; three of these six survived. Results could be
improved by prevention of hepatic artery thrombosis, by decreasing the incidence
of sepsis, and by procurement of more and better suited pediatric donors