Paediatric liver transplantation in Australia and New Zealand: 1985‐2018

Stormon, Michael; Hardikar, Winita; Evans, Helen; Hodgkinson, Peter

doi:10.1111/jpc.14969

Cited by 12 publications

(16 citation statements)

References 43 publications

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“…In United Kingdom the 1-year survival probability for children undergoing liver transplant is 95.7% [3]. Australia reported 1-year survival of 97% [4]. Slightly lower survival probability are found in Asian centres but comparable among each other, including Shanghai 91.36% at 1 year [5], Hong Kong 91% at 1 year [6], Taiwan 92% at 2 years [7] and Singapore: 85.7% at 1 year [8].…”

Section: Discussionmentioning

confidence: 99%

An Overview of Paediatric Liver Transplant in Hospital Selayang: 2002 to 2015

Kam

Lim

2021

MJPCH

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Introduction: Hospital Selayang started the liver transplant program in 2002. We report a total of 81 liver transplant cases until year 2015. Among these, paediatric cases constitute almost half. This report aims to review the demography and outcome of paediatric liver transplant cases. Methodology: Case notes of all paediatric patients underwent liver transplant from year 2002 to 2015 were retrospectively reviewed. Results: A total of 38 paediatric cases received liver transplantations from year 2002 to 2015. Age at transplantation ranged from 11 months to 16 years old (mean age 6 years) and weight ranged from 6.47 to 63 kilogram (mean 18kg). There were 20 males and 18 females, 20 of them were Malay, whereas Chinese and Indian were 13 and 4 respectively. Eighteen cases were living-related and 20 cases were cadaveric liver transplants. For recipient blood group, O+ is the commonest. Biliary atresia was the most common indication for liver transplant (22 cases; 58%), followed by intrahepatic cholestasis disorders (5 cases; 13%) and metabolic disease (4 cases; 10%). Post transplantation, there were 6 (16%) biliary complications, 12 (32%) vascular complications, 26 (68%) developed early onset infection, 13% had acute rejection and 2 graft failure. Out of the 38 transplants, 79% of them survive after 1 year, and 69.7% survive after 5 years. The common causes of mortality were sepsis and vascular complications. Conclusion: Despite limited resources, a successful paediatric liver transplant programme has been established in Hospital Selayang with good survival rate.

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Section: Discussionmentioning

confidence: 99%

An Overview of Paediatric Liver Transplant in Hospital Selayang: 2002 to 2015

Kam

Lim

2021

MJPCH

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“…Liver transplantation is currently the definitive treatment for most types of liver failure in both children and adults (73)(74)(75)(76). Split grafts, live donations, immunosuppressive regimen upgrades, infectious prophylaxis protocols, and innovative surgical techniques have made it possible to reduce complications and improve survival and quality of life (55)(56)(57)(58)(59)(60)(61)77).…”

Section: Nutritional Interventionmentioning

confidence: 99%

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

Larrosa‐Haro

Caro-Sabido²

2021

Front. Nutr.

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We aimed to conduct an updated review on the pathophysiology, diagnosis, and nutritional intervention of CCLD and secondary malnutrition in infants. Protein-energy malnutrition, impaired linear growth, fat-soluble vitamin deficiencies, and hepatic osteodystrophy can occur in up to 80% of cases. The proposed pathophysiological mechanisms include insufficient energy intake, lipid- and fat-soluble vitamin malabsorption, increased energy expenditure, altered intermediate metabolism, hormonal dysregulation, and systemic inflammation. The current approach to diagnosis is the identification of the deviation of growth parameters, body composition, and serum concentration of micronutrients, which determines the type and magnitude of malnutrition. Currently, liver transplantation is the best therapeutic alternative for the reversal of nutritional impairment. Early and effective portoenteroanatomosis can extend survival in patients with biliary atresia. Medical and dietary interventions in some storage and metabolic diseases can improve liver damage and thus the nutritional status. A proportion of patients with biliary atresia have fat-soluble vitamin deficiencies despite receiving these vitamins in a water-soluble form. With aggressive enteral nutrition, it may be possible to increase fat stores and preserve muscle mass and growth. The nutritional issues identified in the pre- and post-transplantation stages include muscle mass loss, bone demineralization, growth retardation, and obesity, which seems to correspond to the natural history of CCLD. Due to the implications for the growth and development of infants with CCLD with this complex malnutrition syndrome, innovative projects are required, such as the generation of prediction and risk models, biomarkers of growth and body composition, and effective strategies for nutritional prevention and intervention.

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“…2 Untreated BA leads to chronic liver failure and death within the first 6-18 months of life and is the commonest indication for liver transplant (LT) in children, accounting for 54% of LTs in Australia and NZ. 3 The cause of BA is unknown but not thought to be due to a monogenetic cause or a clear infective or toxic aetiology. 4 Disparity in incidence is observed between countries.…”

Section: Biliary Atresiamentioning

confidence: 99%

“…Untreated BA leads to chronic liver failure and death within the first 6–18 months of life and is the commonest indication for liver transplant (LT) in children, accounting for 54% of LTs in Australia and NZ 3 …”

Section: Structural Diseases Of the Biliary Treementioning

confidence: 99%

Neonatal liver disease

Evans

Siew

2020

J Paediatrics Child Health

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Neonatal liver disease encompasses many diagnoses, including structural and genetic aetiologies. Many have significant health implications requiring long‐term specialist treatment including liver transplantation. Jaundice is a common presenting feature. The ability of health‐care professionals to differentiate neonatal liver disease from benign diagnoses such as physiological jaundice is very important. Persistent (more than 2 weeks) of conjugated jaundice always warrants investigation. Severe unconjugated jaundice (requiring prolonged phototherapy) should also be promptly investigated. Recent advances in genomics have enabled previously elusive, precise diagnoses in some patients with neonatal liver disease. This review paper discusses the commoner causes, with a focus on early detection and need for referral to paediatric liver services.

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Paediatric liver transplantation in Australia and New Zealand: 1985‐2018

Cited by 12 publications

References 43 publications

An Overview of Paediatric Liver Transplant in Hospital Selayang: 2002 to 2015

An Overview of Paediatric Liver Transplant in Hospital Selayang: 2002 to 2015

Secondary Malnutrition and Nutritional Intervention in Cholestatic Liver Diseases in Infants

Neonatal liver disease

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