Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/25061
Title: Outcomes for children after second liver transplantations are similar to those after first transplantations: a binational registry analysis.
Austin Authors: Jeffrey, Angus W;Jeffrey, Gary P;Stormon, Michael;Thomas, Gordon;O'Loughlin, Edward;Shun, Albert;Hardikar, Winita;Jones, Robert M ;McCall, John;Evans, Helen;Starkey, Graham M ;Hodgkinson, Peter;Ee, Looi C;Moore, David;Mews, Catherine;McCaughan, Geoff W;Angus, Peter W ;Wigg, Alan J;Crawford, Michael;Fawcett, Jonathan
Affiliation: Sir Charles Gairdner Hospital, Perth, WA
The University of Western Australia, Perth, WA
The University of Sydney, Sydney, NSW
Sydney Medical School, , the University of Sydney, Sydney, NSW
Australian National Liver Transplantation Unit, Royal Prince Alfred Hospital, Sydney, NSW
Starship Children's Health, Auckland, New Zealand
New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand
Victorian Liver Transplant Unit, Royal Children's Hospital, Melbourne, VIC
Victorian Liver Transplant Unit
The University of Sydney, Sydney, NSW
Australian National Liver Transplantation Service, Children's Hospital at Westmead, Sydney, NSW
Sir Charles Gairdner Hospital, Perth, WA
The University of Queensland, Brisbane, QLD
Queensland Liver Transplantation Service, Princess Alexandra Hospital, Brisbane, QLD
Australian National Liver Transplantation Unit, Royal Prince Alfred Hospital, Sydney, NSW
Royal Children's Hospital, Melbourne, VIC
Starship Children's Health, Auckland, New Zealand
Lady Cilento Children's Hospital, Brisbane, QLD
Women's and Children's Hospital, Adelaide, SA
Perth Children's Hospital, Perth, WA
South Australian Liver Transplantation Service, Flinders Medical Centre, Adelaide, SA
Issue Date: Nov-2020
metadata.dc.date: 2020-10-04
Publication information: Medical Journal of Australia 2020; 213(1): 464-470
Abstract: To assess long term graft and patient survival after donor liver retransplantation in children in Australia and New Zealand during 1986-2017; to determine the factors that influence survival. Retrospective cohort analysis (registry data). Australia and New Zealand Liver Transplant Registry data for all liver retransplantations in children (under 18 years of age), 1986-2017, in all four paediatric and six adult liver transplantation centres in the two countries. Graft and patient survival at one, 5, 10 and 15 years. 142 liver retransplantations were undertaken in children (59 during 1986-2000, 83 during 2001-2017). Kaplan-Meier survival analysis indicated that survival was significantly greater during 2001-2017 than 1986-2000 (P < 0.001). During 2001-2017, graft survival one year after retransplantation was 84%, at 5 years 75%, at 10 years 70%, and at 15 years 54%; patient survival was 89% at one year, 87% at 5 years, 87% at 10 years, and 71% at 15 years. Median time between transplantations was 0.2 years (IQR, 0.03-1.4 years) during 1986-2000, and 1.8 years (IQR, 0.1-6.8 years) during 2001-2017 (P = 0.002). The proportion of graft failures that involved split grafts was larger during 2001-2017 (35 of 83, 42%) than 1986-2000 (10 of 59, 17%). Graft type, cause of graft failure, and number of transplants did not influence survival following retransplantation. Survival for children following retransplantation is excellent. Graft survival is similar for split and whole grafts. Children on the liver waiting list requiring retransplantation should have the same access to donor grafts as children requiring a first transplant.
URI: https://ahro.austin.org.au/austinjspui/handle/1/25061
DOI: 10.5694/mja2.50802
ORCID: 0000-0002-9137-0204
PubMed URL: 33015834
Type: Journal Article
Subjects: Ethics
Liver diseases
Liver transplantation
Tissue and organ procurement
Appears in Collections:Journal articles

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