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Development of a Pediatric Liver Transplant Program in a Developing Country: from Deceased to Living Donors. 10-Year Experience

According to national transplant statistic in Colombia, Pediatric liver transplantation represent 20% (n=53) of the total of liver transplant performed in 2015. These numbers are growing in consequence with the improving clinical and surgical experience in this area, starting from liver reduction, split and living donation. Here in, we present our experience in the development as we consider, a complete liver pediatric transplant program in our institution. Materials and Methods Data represents a prospective cohort study of pediatric liver transplants, performed from 2007 to 2017 at Fundación Cardioinfantil, Bogota, Colombia. Data is presented according to the type of donor (Deceased: Reduced/Split, Living), age of the recipient and influence of a highly experience center support and accompaniment. Results and Discussion A total of 98 pediatric liver transplants were performed at our institution during this cohort. Fifty five percent of the patients received a transplant from a living donor. The main indications for transplantation were biliary atresia (42%), acute liver failure (9%), malignancy (8%) and cryptogenic cirrhosis (8%). Forty percent of the transplants were performed in children under 10kg. Main complications were arterial stenosis/thrombosis (3%), suprahepatic or portal vein thrombosis/stenosis (8%) and biliary complication (29%). The rate of 1-year biopsy proven acute moderate or severe rejection was 17%. There was a greater survival among living donor recipients (92% vs 72.9%; p 0.012) influenced by the learning curve and the support of a highly experienced center (before 71.4% vs after 87.1%; p 0.06). Conclusion Survival at our center is high compared with that obtained in similar studies in other countries. The support of a highly experienced center is important in order to achieve better results. Key words: Pediatric liver transplantation.