Farina Junior MA, Utz-Melere M, da Silva CS, Nader LS, Trein CS, Lucchese AM, Machry M, Mariano R, Ferreira CT, Kalil AN, Feier FH. Ten years of a pediatric living donor liver transplantation program in Brazil. World J Transplant 2025; 15(2): 98616 [DOI: 10.5500/wjt.v15.i2.98616]
Corresponding Author of This Article
Flávia Heinz Feier, PhD, Professor, Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Irmandade Santa Casa de Misericórdia de Porto Alegre, Rua Prof Annes Dias, Porto Alegre 90020-090, Brazil. flavia.feier@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Marco Aurélio Farina Junior, Melina Utz-Melere, Carolina Soares da Silva, Luiza Salgado Nader, Cristine Suzana Trein, Cristina Targa Ferreira, Department of Hepatology and Liver Transplantation, Santa Casa de Porto Alegre, Porto Alegre 90050-170, Brazil
Angelica Maria Lucchese, Mayara Machry, Rodrigo Mariano, Antônio Nocchi Kalil, Flávia Heinz Feier, Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil
Antônio Nocchi Kalil, Department of Surgical Oncology, Santa Rita Hospital/Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90050-170, Rio Grande do Sul, Brazil
Author contributions: Farina Junior MA, Utz-Melere M, and Feier FH, designed the research study and wrote the manuscript; Nader LS, Machry M, da Silva CS, Mariano R, and Lucchese AM collected and evaluated the data; Ferreira CT and Kalil AN wrote the manuscript and critically evaluated the final version; All authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the Ethics and Research Committee of the Santa Casa de Misericórdia de Porto Alegre Complex (ISCMPA) (approval number 22289419800005335).
Informed consent statement: Upon signing the informed consent form for liver transplantation, the patients also provided signed authorization for sample collection.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at flavia.feier@gmail.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Flávia Heinz Feier, PhD, Professor, Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplantation, Irmandade Santa Casa de Misericórdia de Porto Alegre, Rua Prof Annes Dias, Porto Alegre 90020-090, Brazil. flavia.feier@gmail.com
Received: July 1, 2024 Revised: November 15, 2024 Accepted: December 11, 2024 Published online: June 18, 2025 Processing time: 235 Days and 10.4 Hours
Abstract
BACKGROUND
Pediatric living-donor liver transplantation is considered a safe alternative for the treatment of children with end-stage liver disease. Experienced tertiary centers and specialized medical staff are necessary to ensure compatible long-term survival rates and quality-of-life for these children.
AIM
To report the results and the 10-year learning curve of a pediatric living-donor liver transplantation program.
METHODS
We conducted a retrospective cohort study of pediatric recipients from 2013 to 2023. Post-transplant outcomes and patient survival rates were compared between two 5-year periods of the program.
RESULTS
A total of 25 and 48 patients underwent transplantation in the first (2013-2017) and second period (2018-2023), respectively. Portal vein and hepatic artery thrombosis occurred in 11 (15.1%) and seven (9.6%) patients, respectively. Biliary complications were observed in 39 of 73 patients (53.4%). A lower warm ischemia time was observed in the second period compared to the first (32.6 ± 8.6 minutes vs 38.4 ± 9.8 minutes, P = 0.018, respectively). Patient survival rates at 1 and 5 years were 84% in the first period and 91.7% in the second period, with no significant difference (P = 0.32).
CONCLUSION
The reported indications and outcomes align with the current literature. Our findings provide crucial evidence regarding the feasibility of establishing a living donor program with consistent results over time.
Core Tip: We present findings related to the implementation of a pediatric living-donor liver transplant center in Brazil, reporting the results of the first 10 years of this program. Complication rates and post-transplant survival are comparable to those obtained at high-volume centers worldwide.
