Abstract

BACKGROUND: Despite excellent transplantation results, there is a vulnerable period of time in the post-transplant management of pediatric liver recipients, which is the time when a child becomes an adolescent. This period of psychological distress influences compliance and may result in premature transplant failure and graft loss. We performed a retrospective review of pediatric liver transplant recipients, transferred to our service for adults, in order to identify key issues associated with transition into the adult care.

MATERIAL AND METHODS: We analyzed medical files of 20 liver recipients transferred from pediatric post-transplant outpatient clinic to the post-transplant service for adults, since year 2000 until December 2015. For survival analyses, Kaplan-Meier model with log-rank test and Cox proportional hazards regression model, to calculate hazard ratio (HR), were used.

RESULTS: Survival rate exceeds 90% in the study population. The major complication was late acute rejection, in most instances due to non-compliance. There were single cases of recurrent liver disease and de novo graft disorders.

CONCLUSIONS: Dedicated service for young people may be needed to optimize outcomes.

Keywords: Adolescent, Liver Transplantation, Patient Compliance, Survival Analysis