Oral

Background:
Liver transplant (LT) is a life-saving procedure for children with liver failure. Long-term complications arising from LT are common and may affect the morbidity and overall prognosis.

Objectives:
We aimed to evaluate the survival and complications of LT in children who were follow-up in single tertiary centre.

Methods:
We conducted a retrospective review of children <18 years, post LT and were followed-up between January 2011 and August 2021. We included all children who had LT in overseas and locally. We collected data on sociodemographics, clinical characteristics pre-LT, 1-year and 5-year post-LT. Data on complications post-LT were collected.

Results:
A total of 69 children were included, 6 were excluded due to incomplete data. The median(IQR) age at LT was 1.5(1.8) years, males 32/69 (46.4%) with a median follow up 2.9(2.8) years. Half (49.3%) of patients had LT performed in Shanghai, China, with increasing number of cases performed locally over the years (Figure 1). Biliary atresia was the commonest diagnosis (47/69, 70%). Most children were on Tacrolimus (57/69, 82.6%).



The overall survival at 1-year and 5-year post LT was 87.9% and 72.4%, respectively. No patient had re-transplantation. At 1-year post LT, the proportion of children who are underweight (weight-for-age Z-score<-2) reduced significantly from 40(61.5%) to 5(8.9%); p<0.001, proportion of stunting (height-for-age Z score<-2) reduced significantly from 46(70.8%) to 14(20.3%); p<0.001. Earlier age of LT was associated with significant improvement in weight and height (height: Rs=-0.297, p=0.0297, weight: Rs=-0.291, p=0.033).
Common complications were infections requiring hospitalisation (52/69, 75.4%), followed by acute graft rejection (26/69, 38.3%). Twenty-eight (40.6%) patients had various types of surgical complications after transplant.

Conclusion:
Current study showed a good overall survival in pediatric LT with excellent catch-up growths. Infection were common after LT in children.