YUCEL YANKOL, MUSTAFA ERTUGRUL, TURAN KANMAZ, NESİMİ MECİT, ILHAN OCAK, OZLEM DURMAZ, KORAY ACARLİ, MUNCİ KALAYOGLU
Experimental and Clinical Transplantation - 2016;14(5):535-541
Objectives: Acute liver failure is a rapidly progressive and life-threatening disease in children, whose clinical features differ from those of adults. Materials and Methods: This is a review of a single center’s experience with pediatric acute liver failure in a region with insufficient deceased donor support. The study is a retrospective review and analysis of 22 pediatric patients with acute liver failure between January 2007 and May 2013. Results: The cause of acute liver failure was indeterminate in 45.4% of cases. Listing for liver transplant was required in 72.7% of patients, whereas 27.3% developed spontaneous remission. In the patients placed on the liver transplant wait list, 75% underwent liver transplant and 25% died before undergoing liver transplant. The presence of ascites, high-grade encephalopathy, and laboratory findings including high lactate dehydrogenase and phos - phorous levels and international normalized ratio were significant parameters in selecting patients needing liver transplants. All liver transplants were from living donors. One- and 3-year patient survival rates after liver transplant were 75% and 75%. No serious donor complications occurred. Conclusions: Living-donor liver transplant may be the only option to save the lives of pediatric patients with acute liver failure, especially in regions with insufficient deceased-donor support. Timely referral to a multidisciplinary transplant center, expedient evaluation of living donors, and appropriate timing of transplant are crucial for a successful outcome.
