Pediatric Liver Transplantation at the Ospedali Riuniti of Bergamo

The pediatric liver transplantation program of the Ospedali Riuniti of Bergamo began in October 1997 when our surgical transplant team moved from the Ospedale Maggiore of Milan, where the first Italian pediatric liver transplant was performed in 1988.
From 1988 to 1997, the number of pediatric liver transplants performed in Italy $ was significantly lower than the national need, and the majority of Italian children with end-stage liver disease, and their families, had to be referred to foreign transplant centers.
Considering that in 1997 the North Italia Transplant (NITp), organized the organ procurement of about 300 cadaver organ donors, we reasoned that the extensive use of the liver splitting procedure would generate enough liver grafts for children, without interfering with the waiting lists of adult patients.
Between October 1997 and September 2000, 108 pediatric liver transplants were performed in 97 children at the Liver Transplantation Unit of the Ospedali Riuniti of Bergamo. The transplanted patients comprised 49 males and 48 females, ranging in age from 0.1 to 20 years. Thirty-four of the transplanted children (37%) were below one year of age, and 64% were under 3-year old $.
The original liver diseases of the patients correspond to the principal indication for pediatric liver transplantation. Ninety-four children underwent primary liver transplantation, while three, previously transplanted elsewhere, received a second graft because of chronic rejection of the first transplanted liver. Of 97 recipients, 6 (6%) were United Network for Sharing Organs (UNOS) status 1, thirteen (13%) were UNOS status 2, and 78 (81%) were UNOS status 3.
Of the 97 recipients $, 66 (68%) received a split liver, in 60 cases a left lateral segment, in 4 cases the left hemiliver and in two cases a right graft (segments I and IV-VIII). Six children (6%) received a reduced-size liver (left lateral segment) and the remaining 25 patients (26%) were transplanted with a whole organ.