Pediatric liver transplantation: fourteen years of experience at the children institute in São Paulo, Brazil

Transplante hepático pediátrico: experiência de 10 anos em um único centro no Brasil

“…6,10-12 In common with what is reported by the majority of pediatric transplant centers, with the exception of Turkey where the primary cause is metabolic diseases, biliary atresia was the most common indication in this sample. 8,[13][14][15][16][17] The fact that the second most common diagnosis among the group of transplant recipients was fulminating hepatitis is related to the priority that these patients are given, receiving donor organs that would probably go to adult recipients, and other studies have also listed this as their second most common indication. 14,16,17 For the subset of patients transplanted due to chronic liver disease, the five-year survival rate is within the range of results obtained by leading transplant centers, where survival rates can reach 90% during the first year and 64.3 to 83.3% after 5 years.…”

“…8,[13][14][15][16][17] The fact that the second most common diagnosis among the group of transplant recipients was fulminating hepatitis is related to the priority that these patients are given, receiving donor organs that would probably go to adult recipients, and other studies have also listed this as their second most common indication. 14,16,17 For the subset of patients transplanted due to chronic liver disease, the five-year survival rate is within the range of results obtained by leading transplant centers, where survival rates can reach 90% during the first year and 64.3 to 83.3% after 5 years. 8,13,[18][19][20][21][22] Primary non-function and thrombosis of the hepatic artery were the principal causes of death of patients transplanted for chronic liver disease, which is a result that differs from other pediatric transplant centers, where infections tend to be the principal cause of death.…”

“…19,27 Thrombosis of the hepatic artery is a severe vascular complication that results in loss of the graft and an indication of immediate repeat transplantation. 3,13,14,17,18 It is more common in the pediatric age group (7 to 8%), to a great extent because of technical difficulties, such as the disproportionate diameters of donor and recipient blood vessels, with greater risk of stenosis and thrombosis at the anastomoses. 3 The rate of hepatic artery thrombosis in this patient sample was 16.6%, which is above what is described in the literature.…”

“…The fact that there were no repeat transplants due to primary non-function is because none of these patients proved able to wait for a new donor. Primary non-function of the liver is a severe complication of the post-transplant period, which can occur in 5 to 16% of cases, 3,[16][17][18]22 and is an indication There are certain limitations to the study design adopted here that should be taken into consideration, primarily with relation to minor complications, since reviewing medical records only makes it possible to record major complications.…”

Prevalence of antibodies against hepatitis A virus among the Kuikuro and Kaiabi Indians of Xingu National Park, Brazil

“…In 1% of the acute cases, however, fulminant fatal hepatitis can occur if not treated with liver transplantion 17,19 . Fulminant Acute Hepatitis A is in fact one of the indications for hepatic transplantation in Brazil 21 . Unusually, benign relapse, non-cirrhotic cholestasis, aplastic anemia and autoimmune disease can occur 17,19 .…”