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. 2024 Nov;31(11):782-797.
doi: 10.1002/jhbp.12062. Epub 2024 Aug 19.

Improved survival of pediatric deceased donor liver transplantation recipients after introduction of the pediatric prioritization system: Analysis of data from a Japanese national survey

Yusuke Takemura  1 , Masahiro Shinoda  2 , Mureo Kasahara  3 , Seisuke Sakamoto  3 , Etsuro Hatano  4 , Tatsuya Okamoto  4 , Yasuhiro Ogura  5 , Yukihiro Sanada  6 , Toshiharu Matsuura  7 , Takehisa Ueno  8 , Hideaki Obara  1 , Yuji Soejima  9 , Koji Umeshita  10   11 , Susumu Eguchi  12 , Yuko Kitagawa  1 , Hiroto Egawa  13 , Hideki Ohdan  14 ; Japanese Liver Transplantation Society
Collaborators, Affiliations

Improved survival of pediatric deceased donor liver transplantation recipients after introduction of the pediatric prioritization system: Analysis of data from a Japanese national survey

Yusuke Takemura et al. J Hepatobiliary Pancreat Sci. 2024 Nov.

Abstract

Background: In Japan, there has never been a national analysis of pediatric deceased donor liver transplantation (pDDLT) based on donor and recipient factors. We constructed a Japanese nationwide database and assessed outcomes of pDDLT focusing on the pediatric prioritization system introduced in 2018.

Methods: We collected data on pDDLTs (<18 years) performed between 1999 and 2021 from the Japan Organ Transplant Network and Japanese Liver Transplantation Society, identified risk factors for graft survival and compared the characteristics and graft survival in pDDLTs conducted before and after the introduction of the pediatric prioritization system.

Results: Overall, 112 cases of pDDLT were included, with a 1-year graft survival rate of 86.6%. Four poor prognostic factors were identified: recipient intensive care unit stay, model for end-stage liver disease/pediatric end-stage liver disease score, donor cause of death, and donor total bilirubin. After the introduction of the system, allografts from pediatric donors were more reliably allocated to pediatric recipients and the annual number of pDDLTs increased. The 1-year graft survival rate improved significantly as did pDDLT conditions indicated by the risk factors.

Conclusions: Under the revised allocation system, opportunities for pDDLT increased, resulting in favorable recipient and donor conditions and improved survival.

Keywords: brain death; cohort studies; graft survival; liver transplantation; pediatrics.

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References

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