Mogul DB, et al. - This paper encompassed the contemplation of changes in patient and graft survival for pediatric liver transplant recipients since 2002. Additionally, researchers sought to ascertain if these outcomes differed by graft type (whole liver transplant, split liver transplant [SLT], and living donor liver transplant [LDLT]). Comparable outcomes were yielded between the use of technical variant grafts and whole grafts, in recent years. Technical variant grafts could be superior for LDLT. Data revealed that the greater use of these variant grafts could offer an opportunity to increase organ supply without compromising post-transplant outcomes.

Methods

• An inquiry was carried out with regard to the patient and graft survival among pediatric liver-only transplant recipients.
• Herein, the PELD/MELD system was implemented with the aid of the Scientific Registry of Transplant Recipients.

Results

• An improvement was displayed in the survival for SLT at 30 days (94% vs 98%; P < .001), and at 1 year for SLT (89% to 95%; P < .001) and LDLT (93% to 98%; P=.002) from 2002-2009 to 2010-2015.
• No variation was identified in the survival for whole liver transplant at either 30 days (98% in both; P=.7) or 1 year (94% vs 95%; P=.2).
• It was determined that the risk of early death with SLT was 2.14-fold higher in 2002-2009 (adjusted hazard ratio [aHR] vs whole liver transplant, _1.472.14_3.12).
• However, this risk disappeared in 2010-2015 (aHR, _0.651.13_1.96), which depicted a notable improvement (P=.04).
• Data illustrated similar risk of late death after SLT in both time periods (aHR 2002-2009, _0.871.14_1.48; aHR 2010-2015, _0.560.88_1.37).
• As per outcomes, LDLT demonstrated similar risk of early death (aHR 2002-2009, _0.491.03_2.14 ; aHR 2010-2015, _0.260.74_2.10) and late death (aHR 2002-2009, 0.520.831.32; aHR 2010-2015, _0.170.44_1.11).
• It was inferred that the graft loss was similar for SLT (aHR, _0.931.09_1.28).
• In actual sense, it was found to be lower for LDLT (aHR, _0.530.71_0.95).