J Pediatr 1990 Aug;117(2 Pt 1):205-10

Liver transplantation in children less than 1 year of age

Sokal EM, Veyckemans F, de Ville de Goyet J, Moulin D, Van Hoorebeeck N, Alberti
D, Buts JP, Rahier J, Van Obbergh L, Clapuyt P, et al
University of Louvain, St. Luc Hospital, Brussels, Belgium

Abstract
Of 139 children who received an orthotopic liver transplant in our center
between March 1984 and July 1989, a total of 17 patients (12%) had transplants
before their first birthday (mean age 10.3 months; range 8 to 11). The mean
weight was 7.3 kg (range 5.2 to 13). Nine retransplantations were performed in
five children because of primary nonfunction (three children), hepatic artery
thrombosis (four), or rejection (two). A reduced donor liver was used for 11 of
26 transplants. Baseline immunosuppression included cyclosporine, prednisone,
and azathioprine with OKT3 or anti-thymocyte globulin for steroid-resistant
rejection episodes. Survivors were discharged after a mean hospital stay of 47
days (range 22 to 87), and nonsurvivors died within a mean of 40 days (range 0
to 120). The 1 year actuarial survival rate was 64.7%, in comparison with 75.8%
in the whole series. One patient died perioperatively, two died from primary
nonfunction, one from adenovirus infection, two from rejection, and one from
bone marrow aplasia. Eighteen rejection episodes, of which 11 were steroid
resistant, occurred in 11 patients. Our series shows that liver transplantation
can be successful in this age group