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Title: ABO Incompatible Liver Transplantation in Children: A 20 Year Experience from Centres in the TransplantChild European Reference Network
Authors: Markiewicz-Kijewska, Małgorzata
Kaliciński, Piotr
Torres Canizales, Juan
Di Giorgio, Angelo
Baumann, Ulrich
Jorns, Carl
Baker, Alastair
Lopes, Maria Francelina 
Frauca Remacha, Esteban
Lopez-Granados, Eduardo
Jara Vega, Paloma
Basso, Maria-Sole
Kowalewski, Grzegorz
Kamińska, Diana
Ferreira, Sandra 
Liccardo, Daniela
Pietrobattista, Andrea
Spada, Marco
On Behalf Of Ern TransplantChild Healthcare Working Group, null
Keywords: AB0-incompatible liver transplantation; Children; Complications; Graft survival; Immunosuppression; Patient survival; Rejection
Issue Date: 31-Aug-2021
Publisher: MDPI
Serial title, monograph or event: Children
Volume: 8
Issue: 9
Abstract: An increasing number of AB0-incompatible (AB0i) liver transplantations (LT) are being undertaken internationally in recent years due to organ shortages and the need for urgent transplantation. The aim of our study was establish the value of ABOi LT from available retrospective results of AB0i pediatric liver transplantations performed in European reference centers now belonging to the TransplantChild, European Reference Network (ERN). Data from medical records were analyzed, including demographic data, diagnosis, urgency of transplantation, time on the waiting list, PELD/MELD score, desensitization procedures, immunosuppression, selected post-transplant complications, and patient and graft survival. A total of 142 patients (pts) with transplants between 1986 and 2018 in 8 European transplant centers were included in the study. The indications for liver transplantation were: cholestatic diseases in 62 pts, acute liver failure in 42 pts, and other conditions in the remaining 38 pts. Sixty-six patients received grafts from living donors, and seventy-six received grafts from deceased donors. Both patient and graft survival were significantly affected by deceased donor type, urgent transplantation, and the development of vascular complications. In the multivariate analysis, vascular complications had a negative impact on patient and graft survival, while a longer time from the first AB0i LT in the study showed better results, suggesting an international learning experience. In conclusion, we believe that AB0i LT in children is now a safe procedure that may be adopted more readily in children.
ISSN: 2227-9067
DOI: 10.3390/children8090760
Rights: openAccess
Appears in Collections:FMUC Medicina - Artigos em Revistas Internacionais

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