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. 2024 Nov;28(7):e14861.
doi: 10.1111/petr.14861.

Failure to Rescue Pediatric Recipients of Living Donor Liver Transplantation: A Single-Center Study of Technical Complications in 500 Primary Grafts

Aniss Channaoui  1 , Catherine de Magnée  1 , Roberto Tambucci  1 , Eliano Bonaccorsi-Riani  2 , Thierry Pirotte  3 , Natalia Magasich-Airola  3 , Thierry Detaille  4 , Laurent Houtekie  4 , Renaud Menten  5 , Dana Dumitriu  5 , Marguerite van den Hove  1 , Pamela Baldin  6 , Françoise Smets  7 , Isabelle Scheers  7 , Giulia Jannone  7 , Etienne Sokal  7 , Xavier Stephenne  7 , Raymond Reding  1
Affiliations

Failure to Rescue Pediatric Recipients of Living Donor Liver Transplantation: A Single-Center Study of Technical Complications in 500 Primary Grafts

Aniss Channaoui et al. Pediatr Transplant. 2024 Nov.

Abstract

Background: The concept of failure to rescue (FTR) has been used to evaluate the quality of care in several surgical specialties but has not been well-studied after living donor liver transplantation (LDLT) in children.

Methods: This study retrospectively reviewed 500 pediatric LDLT performed at a single center between 1993 and 2022. The recipient outcomes were assessed by means of patient and graft survival rates, retransplantation rates, and arterial/portal/biliary complication rates. Graft and patient losses secondary to these complications were calculated regarding FTR for patients (FTRp) and grafts (FTRg).

Results: Overall 1- and 5-year patient survival rates were 94.5% and 92.1%, respectively, the corresponding figures for graft survival being 92.7% and 89.8%. One-year hepatic artery complication rate was 3.6% (n = 18 cases), the respective rates for portal vein complications and biliary complications being 5.7% (n = 57) and 15.6% (n = 101). One-year FTRp rates for hepatic artery thrombosis, portal vein thrombosis, anastomotic biliary stricture, and intrahepatic biliary stricture were 28.6%, 9.4%, 3.6%, and 0%, respectively. The corresponding FTRg rates being 21.4%, 6.3%, 0%, and 36.4%.

Conclusion: Such novel analytical method may offer valuable insights for optimizing quality of care in pediatric LDLT.

Keywords: failure to rescue; immunological complication; living donor liver transplantation; pediatrics; technical complication.

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References

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