Abstract | INTRODUCTION: METHOD: Data were reviewed on 42 transplants in 35 children with A1ATD over 42 yr and compared with 129 transplants in 116 children with biliary atresia (BA). RESULTS: Over 50% of patients were followed up for >10 yr. A1ATD were older than BA at transplantation, median age, 6.0 vs. 1.0 yr (p < 0.0001), and transplanted earlier in the course of liver failure (total bilirubin, 2.7 mg/dL [1.4-6.9] vs. 9.7 mg/dL [2.9-15.4], p = 0.005). Patient survival was greater in A1ATD than BA: one-yr post-transplant, 82.7% vs. 67.9%; five yr, 76.5% vs. 60.2%; and 10 yr, 76.5% vs. 55.9% (p = 0.03). Death-censored graft survival was similar: one-yr post-transplant, 68.4% vs. 66.2%; five yr, 68.4% vs. 55.8%; and 10 yr, 68.4% vs. 52.5% (p = 0.2). Deaths were from infection, hemorrhage, and graft failure <6 months post-transplant. Patient survival improved at five yr from 33.3% pre- cyclosporine (CSA) (1969-1984) (n = 6) to 76.5% in the CSA era (1985-1994) (n = 17) and 100% with tacrolimus (1995-2006) (n = 12) (p = 0.007). CONCLUSIONS:
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Authors | Michael G Hughes Jr, Khalid M Khan, Angelika C Gruessner, Harvey Sharp, Mark Hill, Tun Jie, Raja Kandaswamy, Abhinav Humar, William D Payne, Rainer W G Gruessner |
Journal | Clinical transplantation
(Clin Transplant)
2011 Sep-Oct
Vol. 25
Issue 5
Pg. 731-6
ISSN: 1399-0012 [Electronic] Denmark |
PMID | 21077958
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Copyright | © 2010 John Wiley & Sons A/S. |
Chemical References |
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Topics |
- Biliary Atresia
(mortality)
- Child
- Child, Preschool
- Female
- Follow-Up Studies
- Graft Rejection
(drug therapy, mortality)
- Graft Survival
(physiology)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Infant
- Infant, Newborn
- Kidney Transplantation
(mortality)
- Liver Transplantation
(mortality)
- Male
- Prognosis
- Prospective Studies
- Retrospective Studies
- Survival Rate
- alpha 1-Antitrypsin Deficiency
(mortality)
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