In:
Pediatric Transplantation, Wiley, Vol. 18, No. 4 ( 2014-06), p. 377-384
Abstract:
In case of graft failure, re‐ LTX is the only life‐saving option but it has been associated with inferior results. This study analyzes the outcome following pediatric re‐ LTX with a main focus on the timely relation between initial transplant and re‐ LTX . All pediatric LTX at our institution between 2000 and 2010 divided into patients with primary LTX and patients undergoing re‐ LTX early (≤30 days) or late ( 〉 30 days) after previous LTX were analyzed. Two hundred and ninety‐eight primary LTX (79%), 33 early (9%), and 46 late (12%) re‐ LTX were performed. Patient/graft survival was significantly worse for children undergoing early re‐ LTX compared to primary LTX and late re‐ LTX (p = 0.024/0.001 and p = 0.015/0.03). One‐/five‐yr graft survival rates were 66%/49% for early re‐ LTX compared to 86%/76% for late re‐ LTX and 90%/74% for primary LTX . The inferior results in children undergoing early re‐ LTX were due to events occurring in the first six months with similar survival thereafter. No difference in outcome was evident after adjustment of the groups for high‐urgency status. Outcome was excellent for primary LTX and late re‐ LTX , supporting late re‐ LTX in children. Early re‐ LTX takes an elevated risk of early graft loss and patient death; however, beyond the early postoperative period, the outcome was comparable.
Type of Medium:
Online Resource
ISSN:
1397-3142
,
1399-3046
DOI:
10.1111/petr.2014.18.issue-4
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2008614-3
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