Abstract

There were 3 milestone dates in the development of organ transplantation
in children in CMHI and in Poland. June 23, 1984 - fi rst kidney transplantation; March 1, 1990 - first liver transplantation; and February 20, 2002 - first intestinal transplantation. Since 1984, when transplant program for children was established in our center, we developed to one of the largest pediatric transplant centers in the Europe, with total number of almost 1000 transplants performed in pediatric recipients, including almost 600 kidneys, almost 400 livers, 1 intestinal transplant. All possible types of transplants were introduced during those 25 years, including cadaveric and living related kidney transplants, kidney transplantations with urinary diversion in children with bladder dysfunction; cadaveric whole graft and various variant liver transplants (reduced grafts, partial grafts, split liver grafts) as well from the living donors (left lobe graft, bisegmental grafts, right lobe grafts, monosegmental grafts). We introduced also multiorgan transplants, done in 20 children, mostly combined liver-kidney grafts and one abdominal multivisceral transplant. With the growing experience and general progress as well as new immunosuppressants available we continuously improved results of organ transplantations in children approaching >90% 1 year graft survival in both liver and kidney transplantation and almost 100% patients' survival. The mortality on the pediatric liver and kidney transplantation is almost nil, and this is probably the most important success of the program, which is the only pediatric organ transplant program in Poland. Similar programs are needed for thoracic organ transplantations in children.

Keywords: Liver Transplantation