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Chapter 43 - Liver Transplantation in Children: Indications and Surgical Aspects

from Section V - Other Considerations and Issues in Pediatric Hepatology

Published online by Cambridge University Press:  19 January 2021

By
M. Kyle Jensen ,
Marianne A. Kavan  and
Manuel Rodriguez-Davalos
Edited by
Frederick J. Suchy ,
Ronald J. Sokol  and
William F. Balistreri
Edited in association with
Jorge A. Bezerra ,
Cara L. Mack  and
Benjamin L. Shneider
Frederick J. Suchy
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
Ronald J. Sokol
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
William F. Balistreri
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati
Jorge A. Bezerra
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati
Cara L. Mack
Affiliation:
University of Colorado, Children’s Hospital Colorado, Aurora
Benjamin L. Shneider
Affiliation:
Texas Children’s Hospital, Houston
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Summary

Liver transplantation is the standard of care for end-stage liver disease in children and the vast majority of transplant recipients experience successful outcomes. Better preoperative care, enhanced surgical techniques, and improved immunosuppression strategies have led to the appropriate expectation of good short- and long-term outcomes. Increased indications for liver transplant have led to an ever-increasing number of liver transplant candidates and evaluation of past policies and practices has necessitated changes in allocation policy. Collaboration has also led to better outcomes. Fortunately, continued efforts to expand the use of the donor pool through varied surgical techniques and advanced technology allows more children to benefit from this life-saving and enhancing procedure.

Type
Chapter
Information
Liver Disease in Children , pp. 801 - 815
Publisher: Cambridge University Press
Print publication year: 2021

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References

Squires, RH, Ng, V, Romero, R, et al. Evaluation of the pediatric patient for liver transplantation: 2014 practice guideline by the American Association for the Study of Liver Diseases, American Society of Transplantation and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Hepatology 2014;60(1):362–98Google Scholar
Kim, WR, Lake, JR, Smith, JM, et al. OPTN/SRTR 2016 Annual Data Report: Liver. Am J Transplant 2018;18(Suppl. 1):172–253CrossRefGoogle ScholarPubMed
Kasai, M, Mochizuki, I, Ohkohchi, N, et al. Surgical limitation for biliary atresia: indication for liver transplantation. J Pediatr Surg 1989;24:851–4.Google Scholar
Altman, RP, Lilly, JR, Greenfeld, J, et al. A multivariable risk factor analysis of the portoenterostomy (Kasai) procedure for biliary atresia: twenty-five years of experience from two centers. Ann Surg 1997;226:348–53; discussion 353–5.CrossRefGoogle ScholarPubMed
Otte, JB, de Ville de Goyet, J, Reding, R, et al. Sequential treatment of biliary atresia with Kasai portoenterostomy and liver transplantation: a review. Hepatology 1994;20:41S–8S.Google Scholar
Kamath, BM, Schwarz, KB, Hadzić, N. Alagille syndrome and liver transplantation. J Pediatr Gastroenterol Nutr 2010;50(1):11–15.CrossRefGoogle ScholarPubMed
Perito, ER, Rhee, S, Roberts, JP, Rosenthal, P. Pediatric liver transplantation for urea cycle disorders and organic acidemias: United Network for Organ Sharing data for 2002–2012. Liver Transpl 2014;20(1):89–99.CrossRefGoogle Scholar
Morioka, D, Kasahara, M, Takada, Y, et al. Current role of liver transplantation for the treatment of urea cycle disorders: a review of the worldwide English literature and 13 cases at Kyoto University. Liver Transpl 2005;11:1332–42.CrossRefGoogle Scholar
Sheflin-Findling, S, Annunziato, RA, Chu, J, et al. Liver transplantation for neonatal hemochromatosis: analysis of the UNOS database. Pediatr Transplant 2015;19(2):164–9.Google Scholar
Taylor, SA, Whitington, PF. Neonatal acute liver failure. Liver Transpl 2016;22(5):677–85.CrossRefGoogle ScholarPubMed
Rand, EB, Karpen, SJ, Kelly, S, et al. Treatment of neonatal hemochromatosis with exchange transfusion and intravenous immunoglobulin. J Pediatr 2009;155(4):566–71.Google Scholar
Narkewicz, MR, Horslen, S, Hardison, RM, et al. A learning collaborative approach increases specificity of diagnosis of acute liver failure in pediatric patients. Clin Gastroenterol Hepatol 2018;16(11):1801–10.CrossRefGoogle ScholarPubMed
Lee, WS, Sokol, RJ. Mitochondrial hepatopathies: advances in genetics, therapeutic approaches, and outcomes. J Pediatr 2013;163(4):942–8.Google Scholar
Dimmock, DP, Dunn, JK, Feigenbaum, A, et al. Abnormal neurological features predict poor survival and should preclude liver transplantation in patients with deoxyguanosine kinase deficiency. Liver Transpl 2008;14(10):1480–5.Google Scholar
Mindikoglu, AL, King, D, Magder, LS, et al. Valproic acid-associated acute liver failure in children: case report and analysis of liver transplantation outcomes in the United States. J Pediatr 2011;158(5):802–7.Google Scholar
Amir, AZ, Ling, SC, Naqvi, A, et al. Liver transplantation for children with acute liver failure associated with secondary hemophagocytic lymphohistiocytosis. Liver Transpl 2016;22(9):1245–53.Google Scholar
Dhawan, A, Cheeseman, P, Mieli-Vergani, G. Approaches to acute liver failure in children. Pediatr Transplant 2004;8:584–8.CrossRefGoogle ScholarPubMed
Lee, WS, McKiernan, P, Kelly, DA. Etiology, outcome and prognostic indicators of childhood fulminant hepatic failure in the United Kingdom. J Pediatr Gastroenterol Nutr 2005;40:575–81.CrossRefGoogle ScholarPubMed
Baliga, P, Alvarez, S, Lindblad, A, Zeng, L. Posttransplant survival in pediatric fulminant hepatic failure: the SPLIT experience. Liver Transpl 2004;10:1364–71CrossRefGoogle ScholarPubMed
Ng, VL, Li, R, Loomes, KM, Leonis, MA, et al. Outcomes of children with and without hepatic encephalopathy from the Pediatric Acute Liver Failure Study Group. J Pediatr Gastroenterol Nutr 2016;63(3):357–64.Google Scholar
Rivera-Penera, T, Moreno, J, Skaff, C, et al. Delayed encephalopathy in fulminant hepatic failure in the pediatric population and the role of liver transplantation. J Pediatr Gastroenterol Nutr 1997;24:128–34.CrossRefGoogle ScholarPubMed
Trobaugh-Lotrario, AD, Meyers, RL, Tiao, GM, Feusner, JH. Pediatric liver transplantation for hepatoblastoma. Transl Gastroenterol Hepatol 2016;20(1):44.Google Scholar
Palaniappan, K, Borkar, VV, Safwan, M, Vij, M, et al. Pediatric hepatocellular carcinoma in a developing country: is the etiology changing? Pediatr Transplant 2016;20(7):898–903.Google Scholar
Baiges, A, Turon, F, Simón-Talero, M, et al. Congenital extrahepatic portosystemic shunts (Abernethy malformation): an international observational study. Hepatology 2019. doi: 10.1002/hep.30817 [Epub ahead of print].Google Scholar
Khanna, R, Kumar Verma, S. Pediatric hepatocellular carcinoma. World J Gastroenterol 2018;24(35):3980–99.Google Scholar
Mazzaferro, V, Coppa, Sposito C J, et. al. The long-term benefit of liver transplantation for hepatic metastases from neuroendocrine tumors. Am J Transplant 2016;16(10):2892–902.Google Scholar
Organ Procurement and Transplantation Network. OPTN Policies. Available at: https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf#nameddest=Policy_09 [last accessed June 30, 2020].Google Scholar
Organ Procurement and Transplantation Network. Guidance for Pediatric MELD. Available at: https://optn.transplant.hrsa.gov/media/2848/liver_guidance_pediatric_meld_201706.pdf [last accessed June 30, 2020].Google Scholar
Freeman, AJ, Sellers, ZM, Mazariegos, G, et al. A multidisciplinary approach to pretransplant and posttransplant management of cystic fibrosis-associated liver disease. Liver Transpl 2019;25(4):640–57.Google Scholar
Dowman, JK, Watson, D, Loganathan, S, et al. Long-term impact of liver transplantation on respiratory function and nutritional status in children and adults with cystic fibrosis. Am J Transplant 2012;12:954–64.Google Scholar
Organ Procurement and Transplantation Network. OPTN policies national liver review board. Available at: https://optn.transplant.hrsa.gov/media/2197/policy-notice-july-2017-national-liver-review-board.pdf [last accessed June 30, 2020].Google Scholar
Heffron, TG, Pillen, T, Smallwood, G, et al. Liver retransplantation in children: the Atlanta experience. Pediatr Transplant 2010;14(3):417–25.CrossRefGoogle ScholarPubMed
Freeman, RB Jr., Edwards, EB. Liver transplant waiting time does not correlate with waiting list mortality: implications for liver allocation policy. Liver Transpl 2000;6:543–52.Google Scholar
Organ Procurement and Transplantation Network – HRSA. Final rule with comment period. Fed Regist 1998;63:16296–338.Google Scholar
Freeman, RB Jr., Wiesner, RH, Roberts, JP, et al. Improving liver allocation: MELD and PELD. Am J Transplant 2004;4(Suppl. 9):114–31.Google Scholar
Biggins, SW, Rodriguez, HJ, Bacchetti, P, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology 2005;41(1):32–9.Google Scholar
Carey, RG, Bucuvalas, JC, Balistreri, WF, et al. Hyponatremia increases mortality in pediatric patients listed for liver transplantation. Pediatr Transplant 2010;14(1):115–20.Google Scholar
Organ Procurement and Transplantation Network. MELD serum sodium policy changes-OPTN. Available at: https://optn.transplant.hrsa.gov/news/meld-serum-sodium-policy-changes/ [last accessed June 30, 2020].Google Scholar
Hsu, EK, Shaffer, ML, Gao, L, et al. Analysis of liver offers to pediatric candidates on the transplant list. Gastroenterology 2017;153(4):988–95.Google Scholar
Alexopoulos, SP, Nekrasov, V, Cao, S, et al. Effects of recipient size and allograft type on pediatric liver transplantation for biliary atresia. Liver Transpl 2017;23(2):221–33.Google Scholar
Strong, RW, Lynch, SV, Ong, TH, et al. Successful liver transplantation from a living donor to her son. N Engl J Med 1990;322:1505–7.CrossRefGoogle ScholarPubMed
Adam, R, Karam, V, Cailliez, V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) – 50-year evolution of liver transplantation. Transpl Int 2018;31(12):1293–317.Google Scholar
Kasahara, M, Umeshita, K, Sakamoto, S, et al. Living donor liver transplantation for biliary atresia: an analysis of 2085 cases in the registry of the Japanese Liver Transplantation Society. Am J Transplant 2018;18(3):659–68.Google Scholar
Yoo, PS, Olthoff, KM, Abt, PL. Donation after cardiac death in pediatric organ transplantation. Curr Opin Organ Transplant 2011;16(5):483–8.Google Scholar
van Rijn, R, Hoogland, PER, Lehner, F, et al. Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors. PLoS One 2017;12(4):e0175097.Google Scholar
Urata, K, Kawasaki, S, Matsunami, H, et al. Calculation of child and adult standard liver volume for liver transplantation. Hepatology 1995;21:1317–21.Google Scholar
Dahm, F, Georgiev, P, Clavien, PA. Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications. Am J Transplant 2005;5:2605–10.Google Scholar
Kiuchi, T, Kasahara, M, Uryuhara, K, Inomata, Y, Uemoto, S, Asonuma, K, et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors. Transplantation 1999;67:321–7.Google Scholar
Morimoto, T, Ichimiya, M, Tanaka, A, et al. Guidelines for donor selection and an overview of the donor operation in living related liver transplantation. Transpl Int 1996;9:208–13.Google Scholar
Cuende, N, Miranda, B, Cañón, JF, et al. Donor characteristics associated with liver graft survival. Transplantation 2005;79(10):1445–52.Google Scholar
Spitzer, AL, Lao, OB, Dick, AA, et al. The biopsied donor liver: incorporating macrosteatosis into high-risk donor assessment. Liver Transpl 2010;16(7):874–84.Google Scholar
Organ Procurement and Transplantation Network. Guidance for the Informed Consent of Living Donors. Available at: https://optn.transplant.hrsa.gov/resources/guidance/guidance-for-the-informed-consent-of-living-donors/ [last accessed June 30, 2020].Google Scholar
Goldaracena, N, Jung, J, Aravinthan, AD, et al. Donor Outcomes in Anonymous Live Liver Donation. J Hepatol 2019;71(5):951–9.CrossRefGoogle ScholarPubMed
Przybyszewski, EM, Verna, EC, Lobritto, SJ, Martinez, M, Vittorio, JM, Fox, AN, Samstein, B, Kato, T, Griesemer, AD, Emond, JC. Durable clinical and immunologic advantage of living donor liver transplantation in children. Transplantation 2018;102(6):953–60.CrossRefGoogle ScholarPubMed
Knaak, M, Goldaracena, N, Doyle, A, et al. Donor BMI >30 is not a contraindication for live liver donation. Am J Transplant 2017;17(3):754–60.Google Scholar
Miller, CM, Durand, F, Heimbach, JK, et al. The International Liver Transplant Society Guideline on Living Liver Donation. Transplantation 2016;100(6):1238–43.Google Scholar
Ryckman, FC, Flake, AW, Fisher, RA, et al. Segmental orthotopic hepatic transplantation as a means to improve patient survival and diminish waiting-list mortality. J Pediatr Surg 1991;26:422–7; discussion 427–8.Google Scholar
Rodriguez-Davalos, MI, Arvelakis, A, Umman, V, et al. Segmental grafts in adult and pediatric liver transplantation: improving outcomes by minimizing vascular complications. JAMA Surg 2014;149(1):63–70.Google Scholar
Organ Procurement and Transplantation Network. Ethics - split versus whole liver transplantation. Available at: https://optn.transplant.hrsa.gov/resources/ethics/split-versus-whole-liver-transplantation/ [last accessed June 30, 2020].Google Scholar
Vulchev, A, Roberts, JP, Stock, PG. Ethical issues in split versus whole liver transplantation. Am J Transplant 2004;4:1737–40.Google Scholar
Mogul, DB, Luo, X, Bowring, MG, Chow, EK, Massie, AB, Schwarz, KB, Cameron, AM, Bridges, JFP, Segev, DL. Fifteen-year trends in pediatric liver transplants: split, whole deceased, and living donor grafts. J Pediatr 2018;196:148–53.Google Scholar
Govil, S, Shanmugam, NP, Reddy, MS, et al. A metabolic chimera: two defective genotypes make a normal phenotype. Liver Transpl 2015;21(11):1453–4.Google Scholar
Rela, M, Kaliamoorthy, I, Reddy, MS. Current status of auxiliary partial orthotopic liver transplantation for acute liver failure. Liver Transpl 2016;22(9):1265–74.Google Scholar
Squires, JE, Soltys, KA, McKiernan, P, et al. Clinical hepatocyte transplantation: what is next? Curr Transplant Rep 2017;4(4):280–9.Google ScholarPubMed
Ryckman, FC, Fisher, RA, Pedersen, SH, Balistreri, WF. Liver transplantation in children. Semin Pediatr Surg 1992;1:162–72.Google Scholar
Otte, JB, de Ville de Goyet, J, Sokal, E, et al. Size reduction of the donor liver is a safe way to alleviate the shortage of size-matched organs in pediatric liver transplantation. Ann Surg 1990;211:146–57.CrossRefGoogle ScholarPubMed
Emre, S, Umman, V, Cimsit, B, Rosencrantz, R. Current concepts in pediatric liver transplantation. Mt Sinai J Med 2012;79(2):199–213.Google Scholar
Tannuri, U, Mello, ES, Carnevale, FC, et al. Hepatic venous reconstruction in pediatric living-related donor liver transplantation – experience of a single center. Pediatr Transplant 2005;9:293–8.Google Scholar
Heffron, TG, Pillen, T, Smallwood, G, et al. Incidence, impact, and treatment of portal and hepatic venous complications following pediatric liver transplantation: a single-center 12 year experience. Pediatr Transplant 2010;14(6):722–9.Google Scholar
Marwan, IK, Fawzy, AT, Egawa, H, et al. Innovative techniques for and results of portal vein reconstruction in living-related liver transplantation. Surgery 1999;125(3):265–70.Google Scholar
Inomoto, T, Nishizawa, F, Sasaki, H, et al. Experiences of 120 microsurgical reconstructions of hepatic artery in living related liver transplantation. Surgery 1996;119:20–6.Google Scholar
Guarrera, JV, Sinha, P, Lobritto, SJ, et al. Microvascular hepatic artery anastomosis in pediatric segmental liver transplantation: microscope vs loupe. Transpl Int 2004;17:585–8.Google Scholar
Gondolesi, GE. Role for biological meshes for delayed abdominal wall closure after pediatric liver transplantation? Pediatr Transplant 2014;18(6):554–5.CrossRefGoogle ScholarPubMed

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