The authors have no financial disclosures or conflicts of interest.
Liver transplantation for children with Wilson disease: comparison of outcomes between children and adults
Article first published online: 14 OCT 2010
© 2010 John Wiley & Sons A/S
Volume 25, Issue 1, pages E52–E60, January/February 2011
How to Cite
Arnon, R., Annunziato, R., Schilsky, M., Miloh, T., Willis, A., Sturdevant, M., Sakworawich, A., Suchy, F. and Kerkar, N. (2011), Liver transplantation for children with Wilson disease: comparison of outcomes between children and adults. Clinical Transplantation, 25: E52–E60. doi: 10.1111/j.1399-0012.2010.01327.x
- Issue published online: 7 FEB 2011
- Article first published online: 14 OCT 2010
- Accepted for publication 8 July 2010
- chronic liver failure;
- fulminant liver failure;
- liver transplantation;
- Wilson disease
Arnon R, Annunziato R, Schilsky M, Miloh T, Willis A, Sturdevant M, Sakworawich A, Suchy F, Kerkar N. Liver transplantation for children with Wilson disease: comparison of outcomes between children and adults. Clin Transplant 2011: 25: E52–E60. © 2010 John Wiley & Sons A/S.
Abstract: Liver transplantation (LT) is lifesaving for patients with Wilson disease (WD) presenting with fulminant hepatic failure (FHF) or chronic liver disease (CLD) unresponsive to treatment. Aim: To determine the outcome of LT in pediatric and adult patients with WD. Methods: United Network for Organ Sharing data on LT from 1987 to 2008 were analyzed. Outcomes were compared for patients requiring LT for FHF and CLD after 2002. Multivariate logistic regression was used to determine risk factors for death and graft loss. Results: Of 90 867 patients transplanted between 1987 and 2008, 170 children and 400 adults had WD. The one- and five-yr patient survival of children was 90.1% and 89% compared to 88.3% and 86% for adults, p = 0.53, 0.34. After 2002, 103 (41 children) were transplanted for FHF and 67 (10 children) for CLD. One- and five-yr patient survival was higher in children transplanted for CLD compared to FHF; 100%, 100% vs. 90%, 87.5% respectively, p = 0.30, 0.32. One- and five-yr patient survival was higher in adults transplanted for CLD compared to FHF; 94.7%, 90.1% vs. 90.3%, 89.7%, respectively, p = 0.36, 0.88. Encephalopathy, partial graft, and ventilator use were risk factors for death by logistic regression. Conclusion: LT is an excellent treatment option for patients with WD. Patients transplanted for CLD had higher patient survival rates than patients with FHF.