Zhou J, Shen Z, He Y, Zheng S, Fan J. The current status of pediatric liver transplantation in Mainland China.
Pediatr Transplantation 2010: 14:575–582. © 2010 John Wiley & Sons A/S.
Abstract: The aim of this article is to study the current status of pediatric liver transplantation in Mainland China. A total of 337 cases of pediatric liver transplantation enrolled in CLTR between 1993 and May 2009 were analyzed retrospectively. The median transplant age was 8.7 yr (64 day–17.8 yr), and Wilson’s disease was the most common indication (35.4%). Liver transplantation for biliary atresia accounted for 49.3% and 54.2% in 2008 and 2009 and had become the most common indication nowadays. One- and three-yr survival rates of children transplanted at age<1 yr were 69.2% and 59.3%, respectively, and were significantly worse than those transplanted at age≥1 yr (83.9% and 76.6%, p < 0.05).In 63.8% (208/326) of the patients, LDLT was used with an overall one- and three-yr survival rates of 87.5% and 84.4%, respectively. The one- and three-yr survival for DDLT was significantly lower (66.7% and 52.2%, p < 0.05). The one- and three-yr survival rates for those transplanted in era 1993–2000 were 63.6% and 36.4%, respectively, and the one- and two-yr survival rates in the latest era (2007-2009) were markedly improved (81.9% and 79.0%, p < 0.05). Cox’s analysis identified DDLT (HR = 2.90, CI 95% 1.5–5.6), being transplanted in era 1993–2000(HR = 3.4, CI 95% 1.1–10.2), fulminant liver failure (HR = 6.0, CI 95% 2.0–17.5), and malignancy (HR = 3.8, CI 95% 1.4–10.3) as predictors of increased mortality, and children transplanted at age 8–17 yr have an better survival (HR = 0.2, CI 95% 0.1–0.6). We concluded that pediatric liver transplantation is gradually developing and would probably be a promising therapy for pediatric end-stage liver diseases in Mainland China.