BSPGHAN 2021 Virtual Annual Meeting

27- 29 April 2021

PREDICTORS OF PATIENT AND GRAFT SURVIVAL FOLLOWING PEDIATRIC LIVER TRANSPLANTATION: LONG-TERM ANALYSIS OF MORE THAN 300 CASES FROM SINGLE CENTRE

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Jutta Koeglmeier
Jutta Koeglmeier
2 months ago

you are presenting a large retrospective data set of children undergoing liver transplantation. You conclude that the only significant factor for graft and patient survival was the era of transplant (patients after 2010 had better outcomes). Could you please comment on this (eg different immunosuppression, increase in surgical expertise, patient choice)

Amr Alnagar
Amr Alnagar
2 months ago

We examined our experience since 2000 to spot the predictors of patient and graft survival. Our immunosuppression protocol consists of intraoperative methylprednisolone at graft perfusion time followed by tacrolimus, steroids and MMF as maintenance. Our surgical team witnessed few changes in terms of the operating consultants over the years, this allowed building experience from surgical prospective. This was also associated with advances in PICU and postoperative care which further augmented the effect of era of transplantation. Candidates are divided according to listing category into chronic liver failure candidates, acute liver failure candidates, acute on chronic liver failure , metabolic and tumors. Improvement in other related services as nutrition, physiotherapy, play therapy and social services has its added effect on improved outcomes in relation to the era of transplantation as all these factors collectively could improve pre-operative condition of transplant candidates which is definitely reflected on better post operative patient and graft survival. Traditional view of worse outcome in small candidates is can be overcomed by experience in high volume centers.