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Liver 1

Sunday March 26, 2023 - 13:45 to 14:45

Room: Hill Country AB

221.1 Outcome comparison between LDLT and DDT in a cohort of 840 pediatric recipients

Joao Seda Neto, Brazil

TRANSPLANT SURGEON
LIVER TRANSPLANTATION
HOSPITAL SIRIO-LIBANES

Abstract

Outcome comparison between LDLT and DDT in a cohort of 840 pediatric recipients

Joao Seda Neto1, Carolina Costa1, Nathalia Porto1, Marcel R. Benavides1, Rodrigo Vincezi1, Karina Roda1, Renata Pugliese1, Caio Oliveira1, Paulo Chapchap1, Eduardo A. Fonseca1.

1Hepatology and Liver Transplantation, Hospital Sirio-Libanês, São Paulo, Brazil

Background: The outcomes of liver transplantation according to the types of liver grafts used in the pediatric age range have improved over time, and the majority of the reports studying large series show better outcomes with living donor liver transplantation (LDLT). The aim of the present abstract is to analyze the difference in outcomes between LDLT and deceased donor liver transplantation (DDT) in a transplant center with stablished and standardized technique. 
Methods: Retrospective single-center analysis of all liver transplantations in children (<18 years) between 2010 and 2022. Post-operative complications such as HV outflow obstruction (HVOO), hepatic artery thrombosis (HAT), late PV thrombosis (>30 days, LPVT), biliary stricture (BS), biliary leak (BL) and graft survival were compared. 
Results: BW of patients receiving DDT was 31+20.5kg, significantly higher than in the LDLT group (BW=11.9+9.6kg, P<0.01).  Outcome comparison (DDT vs LDLT) were not different for HAT (1.3% vs 1.2%, NS), LPVT (1.3% vs 5.2%, NS), BS (12.5% vc 12.6%, NS), and retransplantation (2.7% vs 2.1%, NS). HVOO (4.1% vs 0.5%.P<0.01) and BL (0% vs 9.7%, P=0.02) were different between groups. Graft survival at 1, 5 and 10 years was 85.8%, 84.3%, and 79.9% in the DDT group, respectively, and 94.4%, 90.3%, and 88.1% in the LDLT group (P=0.03). 
Conclusion: Vascular complications, except for HVOO was similar between groups. Biliary leak was the main problem encountered in the LDLT group (9.7%), despite the use of a standard technique for bile duct reconstruction. Graft survival was significantly better in all time points with LDLT in the present cohort.

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