Ten years of a pediatric living donor liver transplantation program in Brazil

Table 1 Patient demographics and intra-operative variables in the two periods, n (%)

	First period (2013-2017), n = 25	Second period (2018–2023), n = 48	P value
Sex, male	14 (56)	25 (52.1)	0.8
Age at LT, months, median (IQR)	11.2 (7.8-20.7)	12 (6.9-58.1)	0.64
Weight at LT, kg, median (IQR)	7.6 (6.35-11.25)	7.36 (6.4-17.6)	0.67
Z-score weight/age, median (IQR)	-1.33 (-2.85 to 0.45)	-1.1 (-2.31 to -0.19)	0.74
Z-score height/age, median (IQR)	-1.68 (-2.6 to -0.75)	-1.63 (-3.58 to -0.73)	0.95
PELD/MELD	17 (8.5-23)	17 (6-24)	0.99
Liver graft			0.26
LLS	23 (92)	47 (97.9)
LL	2 (8)	1 (2.1)
GRWR, %, mean ± SD	3.38 ± 1.23	3.1 ± 1.45	0.39
TIT, minute, mean ± SD	120.9 ± 42.64	129.4 ± 51.53	0.46
CIT, minute, median (IQR)	75 (57-105)	90 (66.5-111.5)	0.25
WIT, minute, mean ± SD	38.4 ± 9.8	32.6 ± 8.6	0.018
PBCT, mL/kg, median (IQR)	14.2 (0-24.2)	17.7 (1.42-24.5)	0.59
Hospital stay, days, median (IQR)	23 (16-41)	23 (16-31.7)	0.37
ICU stay, days, median (IQR)	8 (7-12)	8 (5-16.5)	0.87

LT: Liver transplant; IQR: Interquartile range; GRWR: Graft-to-recipient weight ratio; TIT: Total ischemia time; CIT: Cold ischemia time; WIT: Warm ischemia time; PBCT: Packed red blood cell transfusion; ICU: Intensive care unit; PELD: Pediatric end-stage liver disease; MELD: Model for end-stage liver disease; LLS: Left lateral segmentectomy; LL: Left lobectomy.

Table 2 Post-transplant complications in the two periods, n (%)

	First period (2013-2017), n = 25	Second period (2018-2023), n = 48	P value
Acute rejection	6 (24)	2 (4.2)	0.01
Chronic rejection	1 (4)	0 (0)	0.34
CMV infection	20 (80)	28 (58.3)	0.07
EBV infection	19 (76)	20 (41.7)	0.007
PTLD	1 (4)	2 (4.2)	1
HAT	4 (16)	3 (6.3)	0.22
Portal vein graft	3 (12)	12 (25)	0.23
PVT	4 (16)	7 (14.6)	1
PV stenosis	3 (12)	8 (17.6)	0.73
HV stenosis	2 (8)	0 (0)	0.11
Bile leak	6 (24)	21 (43.8)	0.12
Biliary strictures	10 (40)	7 (14.6)	0.02
Reoperation	7 (28)	15 (31.3)	1
Retransplant	2 (8)	0 (0)	0.11
Death	4 (16)	4 (8.3)
Clavien-Dindo classification of complications1			0.34
I	0	6 (12.5)
II	12 (48)	17 (35.4)
IIIA	1 (4)	0
IIIB	7 (28)	11 (29)
IVA	2 (8)	8 (16.7)
IVB	1 (4)	2 (4.2)
V	2 (8)	4 (8.3)

¹Considered until hospital discharge.

CMV: Cytomegalovirus; EBV: Epstein-barr virus; PTLD: Post-transplant lymphoproliferative disease; HAT: Hepatic artery thrombosis; PVT: Portal vein thrombosis; PV: Portal vein; HV: Hepatic vein.

Table 3 Multivariate logistic regression analysis for patient survival

	P value	HR	95%CI
GRWR < 1.3%	0.066	5.12	0.89 to 29.3
WIT > 35 minutes	0.068	4.96	0.88 to 27.7

GRWR: Graft-to-recipient weight ratio; WIT: Warm ischemia time; HR: Hazard ratio.